23rd Annual Black & White Gala
Saturday, August 15, 2015
Omni Fort Worth Hotel
Please return by Friday, July 17, 2015 in order to receive full recognition in our
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TABLE LEVELS AND BENEFITS
Seating priority is based on sponsorship level and date payment is received
(Please indicate the number of desired tables at the appropriate level in the blank
to the left.)
Total Purchase Amount:
am unable to attend, but please accept my donation of $
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*** Tables will be prioritized by table level and date contract and payment are
I (We) do not wish to be listed in the program.
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