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Reserve Your Seat at the Philanthropy Summit

Tuesday, May 19, 2009 4:00-7:00PM @ The Waterford, SR 933 South Bend, IN

Please note that there are no issued tickets to the event. Your name will be on a list at the door.

Purchasing a table entitles you to signage and inclusion of your business/group in the Still Making a Difference slideshow. We'll contact you to get information on how your group makes a difference so that we can add it to the community-wide composite of stories.

Non-profits: If you're interested in being part of the Non-Profit Expo, please contact us.

Questions? Contact us.

REGISTRATION FORM

I'd like to purchase a table of 8 and have my business/group included in the Still Making a Difference project. ($320)
I'd like to purchase  individual tickets at $30 each.
I cannot attend, but I'd like to donate  to Make a Difference Michiana.

GRAND TOTAL

Grand Total:

YOUR INFORMATION

Name: *
Company Name: *
Address: *
City: *
ST: *
Zip: *
Phone: *
Email: *
  * - required field
Please list the names of others in your party, OR names of those with whom you'd like to be seated:

PAYMENT OPTIONS

Please to pay on-line. You will be directed to our secure partner site, Paypal, to pay by check or credit card.

If you would prefer not to take advantage of our on-line payment option, please to submit your information via email and mail your payment to:

Make a Difference Michiana, Inc.
P. O. Box 4073
South Bend, IN 46634
Phone: (574)232-3660 ext. 214
 
 
 

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