Judson Center Gala Sponsor Registration Judson Center Gala Registration Select your level of sponsorship Company or Individual Sponsor Name(Required)As it should appear in print.Select Option(Required) Sponsorships, Tables and Ads Event Tickets Make a Donation Sponsorships, Tables and AdsSelect Level or Item(Required)Gold $25,000Silver $10,000Bronze $7,500VIP table $5,500General Table $3,500Activity $3,000Program Ad $1,000Upload Company Logo (Optional)Accepted file types: jpeg, png, Max. file size: 50 MB. Event TicketsIndividual Tickets Quantity Price: $300.00 Quantity Couples Ticket(s) Quantity Price: $550.00 Quantity Make a DonationDonation Amount Contact InformationPrimary Contact(Required) First Last Primary Contact Email(Required) Enter Email Confirm Email Phone(Required)Ext.Phone Type(Required) Mobile/Cell Office Address(Required) Street Address (include suite or apt.#) 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 Secondary Contact Person(Required)Would you like us to work with a member of your staff on logistics (guest names, ads, etc.)? Yes No Secondary Contact Name First Last Secondary PhoneSecondary Email Amount Due Payment Method(Required)Please choose method...Check (An invoice will be emailed.)EFT, ACH, DAFs (Bank instructions will be emailed.)Credit Card - Pay NowDue to service fees, Check, EFT, ACH, DAF are preferred, but Credit Cards are welcomed. We appreciate your support. Credit Card(Required) American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Security Code Cardholder Name
