(DonateBOIStep1)


Step 1 Donation Information Step 2 Verification page Step 3 Credit Card Information

2010 Best of Illinois Dinner

Online ticket and table sales will be available until 5pm Thursday, May 20, 2010.

I would like to make a donation in honor of Chip Halverson.

dollars
(amount of donation)

Tickets

Individual tickets include: cocktail reception, reserved seat for dinner, participation in the live auction, and the opportunity to take part in the Fund-A-Cure program.

Individual Tickets

tickets $325 each
(number of tickets)

Tables

Tables include ten individual tickets.

The JDRF office will contact you to confirm your guest information and commemorative program book listing.

$3,500 Level

tables $3,500 each
(number of tables)

$5,000 Level

tables $5,000 each
(number of tables)

$7,500 Level

tables $7,500 each
(number of tables)

$10,000 Level

tables $10,000 each
(number of tables)

Ads Ad space is available in the commemorative book. Deadline for all ads is May 11, 2010.

Full Page Tribute Ad

$500

(number of ads)

Half Page Tribute Ad

$300

(number of ads)

Quater Page Tribute Ad

$100

(number of ads)

Donations of $3,500 and above will be listed in the program book. Please specify how you would like your listing to appear.

(your name)

Donations of $5,000 or more will receive an ad in the commemorative book. Please see the ad specs for details.

Guest Information (names, mailing address, email address) List first and last name of each guest.

Sample:
Mr. and Mrs. John Smith
123 Main Street
City, State Zip
jsmith@aol.com

Please Note: Tickets will not be mailed. Guests will register by last name upon arrival at the event.

Person Who Asked You to Purchase Tickets or Donate:


		= Required Fields
		Billing Information
Cardholder's Name:
		This address MUST match your credit card billing address
Billing Address 1:
Billing Address 2:
City:
State:
Zip Code:
Cardholder's Main Phone:		() - Extension:
Your E-mail Address:


		Additional Information
Home Phone:		() - (If different from main phone)
Business Phone:		() - Extension: (If different from main phone)
Company or Employer's Name
Age:
Family Member with Diabetes:		Husband Wife Self Child Friend
Family Member with Diabetes:		Other (Please specify):
Please Send me:		JDRF's Newsletter
Please Send me:		Additional Information about JDRF Illinois


If you would like an alternate way to give please call 312/670-0313. JDRF Illinois 500 North Dearborn, Suite 305 Chicago, Illinois 60654-3387 JDRF is an accredited 501(c)(3) nonprofit agency; all donations (including membership donations) are tax deductible.

© 2003-2010 JDRF Illinois