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United Way of Siouxland's Women's Power Lunch Reservation Form
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Required 1.

Please enter your contact information below.

First Name:
Last Name:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
City:
State/Province
(US/Canada):
Postal Code:

2.

Table Tickets


Gold ($1,250) Includes 10 luncheon tickets, 10 VIP reception tickets, name on program, and mention at event.

 

Silver ($500) Includes 10 luncheon tickets and name on program.

 

Please indicate if you wish to purchase a table and the number of tables you wish to purchase below.

 

 

 
 

50 characters left.
3.

Individual Tickets

$50 each (luncheon only)

$75 each (VIP reception only, luncheon ticket sold separately)

Please indicate if you wish to purchase an individual luncheon ticket and/or individual VIP reception ticket and the number of tickets you wish to purchase. 

 

 

 

 

 

 
 

50 characters left.
4.

Please indicate if you would like to request a vegetarian meal and if you have any special needs (i.e. allergy, seating requirement, etc.)

 

 
 

50 characters left.
5.

Power of the Purse Raffle Tickets

 

$5 each or 5 for $20

 

Please indicate the number of raffle tickets you wish to purchase below.

 

 

 
 

50 characters left.

If you would be interested in donating a purse for the Power of the Purse raffle please call our office to make arrangements. 712-255-3551.

 

 
 
6.

Thank you for reserving tickets to United Way of Siouxland's 12th Annual Women's Power Lunch! Please select a payment option below.

 

 
I will call United Way to pay with a credit card. (255-3551)
Please email me the invoice.
Please bill me at the address provided above.
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7.

Message or Comment:

 
 

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