SAVE THE DATE

To purchase tickets for the Student Leadership Benefit Gala on April 26, 2006, please complete the following form or contact Victoria Piluso at 415-362-2480, ext. 214

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CONTACT INFORMATION:

Name

Organization

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Preferred Phone

E-mail

GALA TICKETS:

Gala Tickets ordered before 3/31/06

@ $100.00

Gala Tickets, Non-Members and Guests

@ $150.00

CASH CONTRIBUTIONS:
If you would like to participate but are unable to attend the Gala or would like to make an additional cash donation to the Student Leadership Program please select the amount of your contribution below.

Cash Contribution to the Student Leadership Program

SILENT AUCTION ITEMS:
Please describe below any items that you would like to donate (deadline April 1, 2006) for the Silent Auction which will take place the night of the Gala.

Is there any additional information that we should know?

Thank you for your support.. A representative form The Student Leadership Foundation will contact you shortly to finalize your choices