Gala Registration form

sponsorship

Name:

Company:

Address:

City:

Province:

Postal Code:

Telephone:

Fax:

Email:

Please select a sponsorship level

(Event full page advertisement)

Platinum $15,000
Gold $5,000
Wine $3,000
Silver $2,500
Bronze $1,000
Clear

Advertising Opportunities

(An opportunities will be provided to advertise in our Event booklet.There is one of thise three category to choose form)

Half page AD $500
Quarter page AD $250
Card Size AD $100

Clear

Registration

Contact Name:

Company:

Address:

Telephone:

City:

Province:

Postal Code:

Please reserve table(s) (Table of 8 guests)
($1040)Table or Tickets $130 per person

(An official receipt will be issued for the donation portion of the fee) | Business No. 10747 6053 RR0001

Please indicate your method of payment: (Tickets to follow)

Visa MasterCard Cheque

VISA/MC No. Expiry Date (Month/Year):
Cardholder name:

Cheque Number :

For Your seat reservations,please indicate first and last names and addresses for individual taxt receipts.
Tax receipts will be issued according to Canada Customs and Revenue Canada Rules and Regulations.

Petty Agrapidis | Co-ordinator Special Events and Annual Giving

Tel. 416.654.7718 ext. 2228 . pagrapidis@hellenichome.org

Hellenic Home for the Aged Inc.

Head Office

33 Winona Drive
Toronto, Ontario
M6G 3Z7

For General Information call:
(416) 654-7700

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