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Please verify reCaptcha before submitting the form.
CONTACT INFORMATION
*
First Name
*
Last Name
*
Email Address
*
Phone Number
*
Street Address
Suite or Apt. #
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
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Indiana
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Maryland
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Ohio
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Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip Code
SPONSORSHIP SELECTION
SPONSORSHIP LEVEL
COST
INCLUDES
Friend
$180
Scroll Entry Only
Patron
$360
One Seat | Scroll Entry
Guardian
$720
Two Seats | Scroll Entry
Pillar
$1,000
Two Seats | Scroll Entry
Benefactor
$1,800
Two Seats | Scroll Entry
Leader
$2,500
Two Seats | Scroll Entry
Builder
$3,600
Two Seats | Scroll Entry
Giver
$5,000
Two Seats | Scroll Entry
Founder
$10,000
Five Seats | Scroll Entry
Ambassador
$18,000
Five Seats | Scroll Entry
Advocate
$25,000
Ten Seats | Scroll Entry
Pioneer
$36,000
Ten Seats | Scroll Entry
Champion
$50,000
Ten Seats | Scroll Entry
Luminary
$100,000
Ten Seats | Scroll Entry
*
My/Our Sponsorship Level
Please Select a Level
Friend | $180
Patron | $360
Guardian | $720
Pillar | $1,000
Benefactor | $1,800
Leader | $2,500
Builder | $3,600
Giver | $5,000
Founder | $10,000
Ambassador | $18,000
Advocate | $25,000
Pioneer | $36,000
Champion | $50,000
Luminary | $100,000
ATTENDEE INFORMATION
*
Will you be using your seat?
Please Select an Option
One Seat
None
*
How many of your two (2) seats will you use?
Please Select an Option
One Seat
Two Seats
None
*
How many of your five (5) seats will you use?
Please Select an Option
One Seat
Two Seats
Three Seats
Four Seats
Five Seats
None
*
How many of your ten (10) seats will you use?
Please Select an Option
One Seat
Two Seats
Three Seats
Four Seats
Five Seats
Six Seats
Seven Seats
Eight Seats
Nine Seats
Ten Seats
None
SPONSORSHIP ATTENDEE DETAILS
*
Sponsorship Attendee 1 - Full Name
*
Sponsorship Attendee 2 - Full Name
*
Sponsorship Attendee 3 - Full Name
*
Sponsorship Attendee 4 - Full Name
*
Sponsorship Attendee 5 - Full Name
*
Sponsorship Attendee 6 - Full Name
*
Sponsorship Attendee 7 - Full Name
*
Sponsorship Attendee 8 - Full Name
*
Sponsorship Attendee 9 - Full Name
*
Sponsorship Attendee 10 - Full Name
DIATARY RESTRICTIONS
Please list any diatary restrictions for the above attendees
ADDITIONAL SEATS
*
Would you like to purchase Additional Seats?
Please Select an Option
No
One Additional Seat Ticket
Two Additional Seat Tickets
Three Additional Seat Tickets
Four Additional Seat Tickets
Five Additional Seat Tickets
Six Additional Seat Tickets
Seven Additional Seat Tickets
Eight Additional Seat Tickets
Nine Additional Seat Tickets
Ten Additional Seat Tickets
ADDITIONAL ATTENDEE DETAILS
*
Additional Attendee 1 - Full Name
*
Additional Attendee 2 - Full Name
*
Additional Attendee 3 - Full Name
*
Additional Attendee 4 - Full Name
*
Additional Attendee 5 - Full Name
*
Additional Attendee 6 - Full Name
*
Additional Attendee 7 - Full Name
*
Additional Attendee 8 - Full Name
*
Additional Attendee 9 - Full Name
*
Additional Attendee 10 - Full Name
DIATARY RESTRICTIONS
Please list any diatary restrictions for the above attendees
SEATING REQUESTS
*
Do you have any Seating Requests?
Please Select an Option
No
Yes
*
Please indicate your seating requests below
SCROLL AD ENTRY
*
Would you like to use your Scoll Ad Entry?
Please Select an Option
Yes
No
*
Is this Sponsorship on behalf of a Company/Organization?
Please Select an Option
Yes
No
*
Company/Organization Name
Please enter the text as you would like shown in your Scroll Ad Entry
Please upload a file of your Scroll Ad Entry
ADDITIONAL DONATION
*
Would you like to make an Additional Donation?
Please Select an Option
Yes
No
*
Please enter your Additional Donation amount below
TOTAL AMOUNT OWED
Tue, May 20 2025 22 Iyyar 5785
