A Just Harvest Secure Event Registration Form


9th Annual Awards Banquet and Benefit
"...and it was good." - Genesis 1
Sunday, October 14, 2012
5:00 p.m.
Mid-America Club, Aon Center, 80th Floor
200 E. Randolph St., Chicago

2012-2013 Annual Magazine Advertising
I would like to support A Just Harvest by purchasing an advertisement in the 9th Annual Awards Banquet and Benefit Annual Magazine. The 2012-2013 Annual Magazine also serves as the organization’s 2011 annual report and will be distributed widely beyond the banquet.

 Full Page $1000 (8.5 x 11 no bleed)
 Half Page $500 (8.5 x 5.5 no bleed)
 Quarter Page $250 (4.25 x 5.5 no bleed)
 Eighth Page $125 (4.25 x 2.75 no bleed)
 Not at the moment

Note:
Ads should be submitted as camera ready .jpeg files (300 dpi). Please contact Cindy Bush at 773-262-2297 x22 with any questions about ad specifications. The deadline for advertisement purchase and submission is Friday, September 7, 2012.

Banquet Tickets
I would like to support A Just Harvest by purchasing tickets to the 9th Annual Awards Banquet and Benefit.
A table seats 10. The deadline for ticket purchases is Friday, October 5, 2012.

Please reserve tickets for me at $125 per person. .00

Banquet Donations

I am unable to attend however, I would like to donate to support
A Just Harvest:
(No commas, spaces, or non-numeric characters, please)  
.00

Meal preference:
Attendee #1:  Attendee #2:  
Attendee #3:  Attendee #4:  
Attendee #5:  Attendee #6:  
Attendee #7:  Attendee #8:  
Attendee #9:  Attendee #10: 

Celebrate Rev. Marilyn Pagán-Bank’s 10th Anniversary by Adding 10%
 Click here to donate an extra 10% in celebration of Rev. Marilyn Pagán-Bank’s 10th anniversary in ministry at A Just Harvest. 

Total Amount: $ 


Please list the names of people attending: (Optional)

*First Name:   *Last Name:  
*Address 1:   Address 2:  
*City:   *State:  
*Zip Code:   *E-mail:  
*Daytime Phone#:   *Evening Phone#:  

Company Name (If applicable):



*Payment Type:   Credit Card   Check 

If by Credit Card:

If by Check:
*Credit Card Type:
*Credit Card # :
*Routing # :
Where do I find this?
*Exp. Date: /
*Checking Account #:
Where do I find this?

After ensuring that all of the information above is correct,
please click the Submit Form Now button ONLY ONCE.
Multiple clicks of the Submit button will result in duplicate charges to your account.
An email confirmation will be sent to the email address you provided.

 


  
A Just Harvest
PO Box 608033 • Chicago, IL 60626 • Phone: 773-262-2297
Send us an e-mailwww.ajustharvest.org


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