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2024 Dragonfly Grand Gala, presented by Cincinnati Children's Hospital Medical Center Sponsorship & Ticket Form
Dear Guest,
Thank you for your support of our Grand Gala, presented by Cincinnati Children's Hospital Medical Center.
Please use this form to register for your sponsorship or purchase individual tickets. If you would like to pay with a check please contact Lynette Rosati at l.rosati@dragonfly.org.
GALA SPONSORSHIP OPPORTUNITIES
Please select...
Presenting Sponsor ($25,000) SOLD OUT!
Hero Sponsor ($12,500)
Mission Sponsor ($10K)
Strength Sponsor ($5K)
Courage Sponsor ($3K)
Joy Sponsor ($1,500)
Note: Please see website or sponsorship materials for benefit details.
INDIVIDUAL TICKETS
($200/Per Person):
Please select...
Please select quantity
1
2
3
4
5
6
7
8
MAKE A DONATION
I would like to support this event with a monetary donation.
$
PURCHASE SUMMARY
Grand Gala $
Donation $
TOTAL TRANSACTION
$
CONTACT/BILLING INFORMATION
**To maximize sponsorship benefit, please email your logo to l.rosati@dragonfly.org
REQUIRED: Type of Sponsorship/Donation
Please select...
Individual
Organizational
First Name
Last Name
Email
Mobile Phone
Please use hyphens, not periods or slash marks
x
Work Phone
Company Name
Street Address
City
State
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AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HA
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
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WI
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PR
VI
MP
GU
AS
PU
Zip Code
PAYMENT INFORMATION
Name As It Appears On Card
Billing Email
Credit Card Type
Please select...
Visa
MasterCard
American Express
Discover
Card Number
MM
YY
CVV Code
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