HPJC Peacemaker Awards Dinner Reservation Form

Make Your Reservations for the Reception

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Peacemaker Reception:

Come meet the Awardees at a special reception

SATURDAY, Nov. 9th

2:30 - 4:30 PM at Redbud Gallery, 202 East 11th Street, Houston, TX 77008.

Ticket Price is $75 and includes a copy of Roxanne Dunbar Ortiz's latest book
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Peacemaker Awards Dinner:

ONLINE Registration for the Awards Dinner is closed. Registration for the Saturday reception is still open, though.

If you would like to come to the dinner and

you have not already registered, we may

not be able to seat you for a meal.

If we are not able to seat you for a meal, you will be welcomed to sit in the ballroom to hear the program.

Please consider a donation for the program.

Gather with old friends & new to celebrate the 2019 Peacemakers

Roxanne Dunbar-Ortiz, Author & Activist

Egberto Williies

Judge Lina Hidalgo

Undies For Everyone

SUNDAY, Nov. 10th

Social Hour, Cash Bar & Silent Auction 5:00-6:00 PM

Dinner & Program begin at 6:00 PM

Crown Plaza Hotel---2712 Southwest Freeway---Houston, TX 77098

Ticket price: $100 until Nov. 3

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More details and updates about both the reception and dinner are on the

HPJC Awards Dinner Web Page
Attendee Information
1st Person (you)*

Choose Reception onlyFirst NameLast Name
Your E-mail*
2nd Person

Choose Reception onlyFirst NameLast Name
2nd Person's E-mail
example@example.com
3rd Person

Choose Reception onlyFirst NameLast Name
3rd Person's E-mail
example@example.com
4th Person

Choose Reception onlyFirst NameLast Name
4th Person's E-mail
example@example.com
5th Person

Choose Reception onlyFirst NameLast Name
5th Person's E-mail
example@example.com
If you are making reservations for more than 5 people, please list the names of the additional people and the entree choice and events to be attended for each in the "Addition Information" box at the bottom of this form.

Also if any of your dinner attendees have food allergies, please list his/her name along with the type of allergy.
Click here to buy a full table of ten seats for $1000. Thank you for supporting us - you will be mentioned in our program and have an option of having space at an information table before the dinner begins.

I want to pay for a table for 10 people
Do you want to buy a full table of ten seats for $1000? Thank you for supporting us - you will be mentioned in our program and have an option of having space at an information table before the dinner begins.

YesNo
How would you like your table to be named
Please list, to the best of your ability, names/email addresses/food prefs of people attending. You can list the first five above, and list the others (if you know who they are now) in the Additional Info box at the bottom. We will be contacting you two weeks before the dinner for additional info.
Your Phone Number*
Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
AWARDS DINNER SEATING: Most attendees will be free to find seating at the Awards Dinner at any non-reserved tables. If you are making reservations for three or more, we will try to assign you all to the same table. Each table seats a maximum of ten. If you need other seating accommodations, please let us know and we will do our best.
Describe seating accommodations above.
Tell us how many Sunday, Nov. 10th Awards Dinner reservations to make (including people listed above and any TBD's) here.
Dinner Reservations
Tell us how many Saturday, Nov. 9th, Peacemaker Reception reservations to make (including people listed above and any TBD's) here.
Reception Reservations
NOTE: These events are HPJC's primary fundraiser for the year, and we depend on extra donations to fund our work.
Please consider giving more than the ticket prices and/or becoming a member of HPJC (or renewing your membership), to support our work for peace and justice, to fund our activities throughout the year, and so that people of slender means can attend at discounted rates.
Extra Donation Amount
Enter dollar amount
If you're paying an additional amount as noted above to be an underwriter, please list your name(s) here as you want to be listed in the program booklet. Leave blank to be anonymous. Acknowledgements in the program will not indicate donation amounts. THE PROGRAM BOOKLET WILL GO TO PRINT ON NOV. 2nd.
HPJC Membership Selections

Please join HPJC (or gift a membership to HPJC) at a cost $35 per individual or $50 per family!
Number of HPJC individual memberships at $35 each
Name for each individual membership and the email address of each
Example entry: Sally Johnson, sjohnson@noemeail.com John Smith, jsmith@noemeail.com
Number of HPJC family memberships at $50 each
Please list names of each person included in the family membership along with at least one email address.
Example entry: Pat & Mark Smith, pmsmith@noemeail.com Tracy & Lynn Jones, jonestl@noemeail.com
Total Amount Due:
Because of credit/debit card service charges, we prefer that payments $500 or more be made by check, if possible. Make checks to HPJC and mail to HPJC, PO Box 66234, Houston, TX 77266 along with a print out of this completed registration form. Please choose payment method:

checkcredit/debit card

ADDITIONAL INFORMATION:
IMPORTANT: Be sure to click on the "Submit Form" button below to record your registration. Clicking on "Submit Form" will also record your credit/debit card payment, if you chose that payment option.

Thank you for your support of HPJC, and we look forward to seeing you at the Awards Dinner on SUNDAY, November 10 and/or The Peacemaker Reception on SATURDAY, November 9.
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