Benefit Gala Table Form 2015

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23rd BENEFIT GALA TABLES, TICKETS &UNDERWRITING FORM Please select one of the following: TABLES Platinum Table - $10,000

Gold Table - $5,000

(Includes 10 guests per table, a Platinum Journal Page and Premier Seating)

(Includes 10 guests per table, a Gold Journal Page & Premier Seating)

Silver Table - $2,500 (Includes 10 guests per table, a Silver Journal Page & Premier Seating)

TICKETS Platinum Benefactor Tickets - $1,000 each (Includes special mention in Journal & Premier Seating)

Benefactor Tickets - $500 each (Includes special mention in Journal & Elite Seating)

Patron Tickets - $300 each

Friend Tickets - $200 each

(Includes special mention in Journal)

UNDERWRITING/SPONSORSHIP (All underwriters and sponsors will be recognized in print and online media.)

Event Underwriting - $15,000 Cocktail Reception Underwriting - $5,000 Sponsor a Jesuit or Faculty Member - $185/per person

Dinner Underwriting - $10,000 Decorations Underwriting - $3,000

EVENT DONATION I/We cannot attend the event but would like to make a donation of

.

CHECKOUT Name ____________________________________________________________________________________________________________ Address _________________________________________________________________________________________________________ City ________________________________________ State _________________________________ Zip Code ______________________ Email _______________________________________________________Phone _______________________________________________ PAYMENT INFORMATION Enclosed is a check in the amount of $___________ or Please charge my/our credit card in the amount of $ ____________ Circle one: a) Amex b) Discover c) MasterCard d) Visa Name on Card ____________________________________________________________________________________________________ Credit Card # _____________________________________________________________________________________________________ Authorized Signature ________________________________________Expiration Date _______________ Security Code ___________

Please send your completed form and payment to: Address: Loyola School •Office of Advancement• 980 Park Avenue • New York, NY 10028 Office Phone: 646.346.8135 •Fax: 212.879.4864

On behalf of the 2015 Benefit Gala Committee, thank you for your generous participation!

Looking forward to seeing you on May 8, 2015!


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