Event Registration Form

Thank you for your interest in our event! Please enter your information into the form below. If all information is correct, you will be forwarded on to an external, highly secure website to enter your credit card information.

Step 1: Registrant Information

Event:	A Special Evening with Professor Jeremi Suri
First Name*:
Last Name*:
Home Phone*:
Work Phone:
Address*:
City*:		State: Zip:
Email*:

Pricing

Menu Selection

Please select your dinner choice from the following options:

	1 - Seared lemon herb chicken breast, with roasted garlic mashed potatoes and cabernet reduction
	2 - Grilled top sirloin marinated in red wine and rosemary, with garlic mashed potatoes and cabernet reduction
	3 - Filet of salmon, with warm fingerling potato salad and tomato-basil cucumber relish
	4 - Pasta tossed with olive oil, grilled vegetables, and parmesan cheese

Guest Names and Meal Choice (Tables of 8 or 10 are available)

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Four Star Sponsor - $5,000

Your name in �The Bugle� and your ad included in Gala promotional materials and programs
Your name acknowledged in all media interviews and during Gala presentation
One table (10 seats) reserved for the Gala and named in honor of sponsor
Your name added permanently to the museum�s League of Honor Wall

Three Star Sponsor $2,500

Your name included in Gala promotional materials, programs and �The Bugle�
One table (10 seats) reserved for the Gala and named in honor of sponsor
Your name added for one year to the museum�s League of Honor Wall

Two Star Sponsor $1,500

Your name included in Gala program and �The Bugle�
One table (10 seats) reserved for the Gala and named in honor of sponsor

Sponsor a Hero $100

Underwrite the cost for a current member of the military (who served in Iraq or Afghanistan) to attend the event.
Sponsor receives mention in all media coverage
Photo of sponsor with veteran they sponsored