Ticket & Table Order Form Name TABLES $100,000 ($95,500 is charitable contribution) $100,000 ($95,500 is charitable contribution) Includes three tables of ten (30 of the best seats in the house) 30 tickets to VIP cocktail reception Listing in all press materials Teal Ad (most frequently shown) in the electronic on-screen journal Logo on step and repeat Special mention from the podium $50,000 ($47,000 is charitable contribution) $50,000 ($47,000 is charitable contribution) Includes two tables of ten (20 premier seats) 20 tickets to VIP cocktail reception Teal Ad (most frequently shown) in the electronic on-screen journal Special mention from the podium $25,000 ($23,500 is charitable contribution) $25,000 ($23,500 is charitable contribution) Includes one table of ten (10 premier seats) 4 tickets to VIP cocktail reception Fuchsia Ad in the electronic on-screen journal Special mention from the podium $10,000 ($8,500 is charitable contribution) $10,000 ($8,500 is charitable contribution) Includes one table of ten (10 preferred seats) Lime Ad in the electronic on-screen journal $6,000 ($4,500 is charitable contribution) $6,000 ($4,500 is charitable contribution) LIMITED AVAILABILITY Lime Ad in the electronic on-screen journal TICKETS $3,000 ($2,200 is charitable contribution) $3,000 ($2,200 is charitable contribution) Two tickets (preferred seating) 2 tickets to VIP cocktail reception Lime Ad in the electronic on-screen journal $1000 ($850 is charitable contribution) $1,000 ($850 per person is charitable contribution) Please reserve _ preferred ticket(s) for Tex-Mex Fiesta! at $1,000 per person. $500 ($250 is charitable contribution) $500 ($250 per person is charitable contribution) Single event seat includes dinner & performance. TRIBUTE JOURNAL (ONLY) All Tribute Journal ads are 100% tax deductible Ads will show on-screen at the Tex-Mex Fiesta on October 20th. Levels are distinguished by the frequency with which ads are shown. Ad specs will be sent via email upon receipt of your pledge. Tribute Joural TEAL AD: $5,000 FUCHSIA AD: $2,500 LIME AD: $1,000 JOURNAL COPY DEADLINE: OCTOBER 1, 2022 unable to attend I / WE ARE UNABLE TO ATTEND, BUT WOULD LIKE TO MAKE A FULLY TAX-DEDUCTIBLE CONTRIBUTION OF PAYMENT Name * Company Address * City * State * - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip * Phone * E-mail * Total Amount $ Total amount: $ Farrah Fawcett Foundation is a 501(c)(3) tax-exempt organization Tax ID#20-8076177 Stand Up To Cancer is a division of The Entertainment Industry Foundation, a 501(c)(3) tax-exempt organization. American Cancer Society is a 501(c)(3) tax-exempt organization. To pay by check click HERE to download the form and mail in your payment.
