Purchase Tickets
Annual Charity and Scholarship

Purchase Tickets

CHARITY BENEFIT

Please fill out ALL of your information.

General Information

* Required

Sponsor Information

Platinum Sponsor
Includes One VIP Table of 10, Named
Scholarship, Sponsor Acknowledgement During
Charity Benefit Program, Outside Cover Program
Book Ad, Platinum Website Posting, Platinum
Sponsor Listing, Event Signage, and
Listing on all Event Signage

$15,000.00
Gold Sponsor
Includes One VIP table of 10, Gold Full Page
Program Book Ad, Gold Sponsor Listing
Gold Website Posting, Sponsor Acknowledgement
during Charity Benefit Program
Listing on all Event Signage

$10,000.00
Silver Sponsor
Includes One Priority Table of 10, Silver
Full Page Program Book Ad, Silver Sponsor
Listing, Sponsor Acknowledgement during
Charity Benefit Program

$5,000.00
Bronze Sponsor
Includes One Priority table of 10, Bronze
Full Page Program Book Ad, Bronze Sponsor Listing.
$3,000.00
Table (OF 10) Sponsor
Includes One Priority table of 10,
Program Book Acknowledgement.
$1,900.00
We wish to be listed as follows:
Individual Seating Tickets. Number:
$175.00
Number of medical students, I/We would like to sponsor tickets. Number:
$175.00
Program Book
Outside Back Cover
$5,000.00
Inside Front Cover
$3,000.00
Inside Back Cover
$3,000.00
Full Page
$1,000.00
Half Page
$500.00
Quarter Page
$300.00
Business Card
$100.00
Patron Listing
$50.00
Friend Listing
$25.00
 
I/We are unable to attend. Enclosed is my Donation:
Champion:
$500.00
Benefactor:
$250.00
Donor:
$100.00
Friend:
$50.00
$


   
Total Amount To Pay
$

Payment Information

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