2008 Valentines Dinner Dance

................................ Enrolling is as easy as 1, 2, 3!

REGISTRATION INSTRUCTIONS

To register, please fill out the form below completely. After the form is completely filled out, click 'PAY NOW' and you will be directed to a secure PAYPAL webpage to pay for the total of your Dinner Guests, and any optional Donations/Sponsorships with your credit card or Echeck. Or you can choose to send a check by mail.

For more information, please contact the Bridges office (516)216-1680 or send an email to: GetHelpNow@bridgesofny.org

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STEP 1

Dinner Dance Registration Information

Please fill in the forms below to notate your total number of guests attending, Your Contact Information, Your Table Reservation Request (Your Guests Names), and any Optional Sponsorships/Donations you would like to add.

Number of Guests Attending
(Please check (1) one box only)
	($100.00)	Sign Me Up!
	($200.00)	Sign Me Up + 1 GUEST!
	($300.00)	Sign Me Up + 2 GUESTS!
	($400.00)	Sign Me Up + 3 GUESTS!
	($500.00)	Sign Me Up + 4 GUESTS!
	($600.00)	Sign Me Up + 5 GUESTS!
	($700.00)	Sign Me Up + 6 GUESTS!
	($800.00)	Sign Me Up + 7 GUESTS!
	($950.00)	Reserve a Corporate Table . 10 Guests

Next, Please fill out your contact information below. You may also request the guests seated at your table in the *optional section on the right if you know of other "PAID" guests attending the dinner dance -or- if you are paying for these guests yourself above.
We will do our utmost to accomodate this request, but due to time/ space constraints, we cannot promise these seating arrangements.

* Required Fields

Your Contact Information		Table Reservation Request *Optional
* Name:		You:	You
* Address:		Guest 1:
		Guest 2:
* Phone:		Guest 3 :
* E-mail:		Guest 4:
		Guest 5:
		Guest 6 :
		Guest 7:
		Guest 8:
		Guest 9:

STEP 2
Add Your Sponsorship(s) to your registration
We encourage you to also add a sponsorship to your registration if you are able. Much of the success of the Dinner Dance Fund Raiser depends on the response of this Sponsorship drive by generous people like you!
*** All Underwriter Sponsorships are fully tax deductible.

2008 SPONSORSHIP OPPORTUNITIES
Sponsor a Room for 12 Months:	$3,600.00	I'll sponsor this
Sponsor a Bed:	$2,400.00	I'll sponsor this
Bridging the Gap:	$1,200.00	I'll sponsor this
General Bridges Support:	$75.00	I'll sponsor this
Other Donation:	$50.00	I'll sponsor this
Other Donation:	$25.00	I'll sponsor this
	MY TOTAL	$

STEP 3
Send Payment

		Please choose your prefered payment method below by clicking either "Pay Now" to pay with PAYPAL now or "I'll Send a Check" to complete your online registration. If sending a check, please send promptly to ensure your reservation and table assignments.
		Choose Pay Method:
	Payments are secure with PayPal! Use your e-Check, Visa, Mastercard, Discover, or American Express.	Pay Now with PAYPAL
		Send Check by Mail	Please Mail Checks to: BRIDGES OF NY 250-72 Jericho Turnpike Floral Park, NY 11001 ATTN: "DANCE 2008 "

Bridges of NY would like to Thank You for your support with this year's Event!