Number of Tickets:  

Select Number of Tickets 1 2 3 4 5 6 7 8 9 10

Select Type of Ticket:

Select Ticket Type Event Ticket - $125 Event Patron Ticket* - $200 Event Benefactor Ticket* - $250

* Includes acknowledgement in the Program Book.

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Name(s)

Email

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Indicate how many entrees, for each person you are paying for:

Sundried Crusted Statler Chicken
with Tuscan Bean Ragout

0 1 2 3 4 5 6 7 8 9 10

Roasted Vegetable Napoleon
with Melted Brie

0 1 2 3 4 5 6 7 8 9 10

If you would like to be seated with friends, you may reserve all or part of a table of ten. To guarantee seating preferences, payment must be received from all guests.
I would like the following people to be seated at my table:

1.

6.

2.

7.

3.

8.

4.

9.

5.

10