Re s e r vati o n I nfo rm ati o n __________________________________________________________________________ Name (Please print clearly.) __________________________________________________________________________ Company Name (if applicable) __________________________________________________________________________ Title (if applicable) __________________________________________________________________________ Address __________________________________________________________________________ City State ZIP __________________________________________________________________________ Telephone Email Dietary Preference:
o Vegetarian
Celebration of
SU B U R B A N D I V ER S I T Y 2 016
o Kosher
Tickets/Tables:
o I wish to purchase________ tickets: $250/ticket $__________
Tickets/Tables:
o I wish to purchase________ tables: $2,000/table $__________
S p o n s o r s h i p/J o u rn a l A d o I wish to be a sponsor. Indicate package: ______________________________________ $____________ o I wish to purchase the (please circle) Gold/ Silver/ Full-Page/ Half-Page journal ad for $___________________________ .
M et h o d of Pay m e nt o Enclosed is my check for $___________ (payable to Hofstra University Diversity Celebration).
o I wish to pay by credit card. Amount: $________________________________ o American Express o MasterCard o Visa Name printed on card______________________________________________________ Card number _____________________________________ Exp. date ________________ Signature _________________________________________________________________
Please submit journal ads via email by October 31, 2016. Provide reservation and payment information by November 7, 2016, and return in the enclosed envelope or mail to National Center for Suburban Studies at Hofstra University, 119 Hofstra University, Hempstead, NY 11549-1190. All contributions are tax-deductible to the extent allowed by law. Proceeds benefit diversity-related scholarships, research and community-based initiatives. printed on recycled paper
Reservation Information and Giving Opportunities