Gala Sponsorship & RegistrationGala Donorship and Registration Form"*" indicates required fieldsRegistration Type (Choose One)* Sponsorship Individual TicketsName* First Last Company NameAddress* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Gala Sponsorship Opportunities*Block Builder - $20,000Groundbreaker - $15,000Community Keeper - $10,000Good Neighbor - $5,000Legacy Defenders - $3,500Sustainer - $1,400Gala Ticket Fee*Single Gala Ticket - $175Two Gala Tickets - $350Three Gala Tickets - $525Four Gala Tickets - $700Five Gala Tickets - $875Six Gala Tickets - $1,050Seven Gala Tickets - $1,225Eight Gala Tickets - $1,400Total Names of Attendees*First NameLast NameDietary Restrictions Add RemoveSponsorships include up-to 8 attendees. Please include the First and Last names, and any dietary restrictions of the attendees.Names of Attendees*First NameLast NameDietary Restrictions Add RemovePlease include the First and Last names, and any dietary restrictions of the attendees. Please add addition names for additional tickets.Payment Method*Credit CardPayPal CheckoutMasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name
