SPONSOR TABLE LAYOUT SPONSORS: Please select the SECTION you prefer to sit in from the diagram. We will do our very best to get you in the section you request but it will be first come, first serve. There will be 33 tables in each section. Country For Our Country will not guarantee exact table location. *This is a representation of the layout, not an EXACT diagram.
• SECTION 1: Front • SECTION 2: Middle • SECTION 3: Back
*REQUIRED INFORMATION Name of Contributor* Name of Contact Person* Address/City/State/ZIP* Office Phone* Mailing Address* (if different than listed above:)
SEPT 24, 2011
E-Mail Address* Home/Cell Phone
TICKETS WILL BE HAND DELIVERED
*Address and Name to be delivered to: Donor's name as it should be listed for recognition I do not wish to be listed for recognition.
I wish to decline all benefits
I am unable to attend but please accept my contribution of $ BILLING AND PAYMENT INFORMATION Total amount of contribution $ PAYMENT METHOD Payment enclosed
Please circle one: Visa MC AMEX Credit Card #
Credit Card Exp Date
Cardholder’s name Billing address/City/State/ZIP Cardholder’s signature Please return this form with payment to: Villa di Felicita Care of Country for our Country P.O.Box 4340 Tyler Tx, 75712-4340 A receipt for your charitable contribution to Country for our Country will be mailed to billing address above.