2024 Citation Award Dinner Registration Form

Join us Wednesday, November 6, 2024

Fill out this form to become a table sponsor, pledge a donation, or reserve your tickets.

Every gift supports NCCJ's work of fighting bias, bigotry and racism

and fostering more compassionate, respectful conversations in our community.

Sponsors, wondering what sponsorship level is right for you or your organization? Check out the Sponsorship Chart. (Logo placement starts at the Respect Champion level. Option for a DEI Spotlight starts at Inclusion Champion level.)

How many tickets you would like to reserve?

Your house of worship:

(If you would like to sit with other folks from your congregation, let us know so that we can be sure to seat you together.)

Do you have any of these dietary restrictions?

VegetarianVeganGluten-free

What is the the dollar amount of your donation?

Please invoice me on...

Enter any date between now and June 30, 2025

Do you plan to attend IN-PERSON or VIRTUALLY?

In-person! Please reserve a seat or table for me at Koury Convention Center for Nov. 6Virtually! I prefer to enjoy the event from the comfort of my home.Not sure. Please give me more information about both options.

If you plan to attend virtually, are you interested in a takeout meal from Green Valley Grill?

Yes! Please contact me to confirm menu choices for me/my guests.No thanks. Please make my entire contribution a gift to support NCCJ's work.

Formal Contact Person (the decision-maker or primary contact)

First Name

Last Name

Event Contact Person (who else should we email with event details and questions?)

First Name

Last Name

Contact Info

Area Code

Phone Number

Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

We're grateful for your support and looking forward to celebrating with you on November 6.

NCCJ's small but mighty team is working to make this event a fun, accessible and inspiring evening of community-building and celebration for you and your guests.

Between now and November, Gloria Hoover will be in touch with you to share updates, including any details you and your guests will need (whether you are attending in-person or virtually.) If you have questions in the meantime, please feel free to reach out to Gloria by email at ghoover@nccjtriad.org or by phone at 336-272-0359 x 160.

Note: pledges and/or payments can also be mailed to NCCJ at 713 North Greene Street, Greensboro, NC 27401.