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

2008 Best of Illinois Dinner Tickets Online ticket and table sales will be available until 5pm Monday, June 2, 2008.
Tickets
Individual tickets include: cocktail reception, a reserved seat for dinner, participation in the live auction, and the opportunity to take part in the Fund-A-Cure program.	Individual Tickets	tickets $325.00 each (number of tickets)

Tables
Tables include ten individual tickets. The JDRF office will be contacting you to confirm your guest information and commemorative program book listing.	$3,000.00 Level	tables $3,000.00 each (number of tables)
	$5,000.00 Level	tables $5,000.00 each (number of tables)
	$10,000.00 Level	tables $10,000.00 each (number of tables)
	$15,000.00 Level	tables $15,000.00 each (number of tables)

Additional Donation
I would also like to make a fully tax deductible donation to the JDRF at this time or I am unable to attend, but wish to make a donation.		dollars (amount of donation)
Donations of $3,000 and above will be listed in the program book. Please specify how you would like your listing to appear.	(your name)

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
Shipping information: Tickets will not be mailed. Please register upon arrival at the event.


		= 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


The fair market value of one dinner is $97. The balance of any gift above this amount is tax-deductible as provided by law. If you would like an alternate way to give please call (312) 670-0313. JDRF Illinois 500 North Dearborn, Suite 305 Chicago, Illinois 60610-4901 JDRF is an accredited 501(c)(3) nonprofit agency; all donations (including membership donations) are tax deductible.

© 2005 JDRF Illinois