Thank you for Attending our 2010 Mardi Gras Event:
We have three different ways to attend:

1) Purchase a table. Tables seat 10. This includes corporate signage and your logo displayed throughout the evening on the large screens.

2) Purchase a single seat.

3) Purchase our Valentine-Day Special. Because the dinner falls on the heels of Valentine's Day, we've put together a special price for this special cause.

We'll contact you with details for the evening.
 
  First Name
 
  Last Name
 
  Address
 
 
City State   Zip
 

    
  Home Phone (required)
  — —

  Work Phone (required)
  — —

  E-Mail (required)
 


 

 
  Pay By Credit Card:
  
  Total Amount (items x quantities) ($)
 
  Table: $2000 (ten seats)
Seat: $200
Valentine's Day Special: $300 (two seats)
  Card Number
 
  
  Card Expiration Date
  
  Month    Year 
 

 
 


The Child Neurology Foundation is a tax-exempt 501 (c)(3) organization; all donations are tax-deductable under limits of current law.

 






Child Neurology Foundation
2000 West 98th Street
Bloomington, MN 55431

Local: (952) 641-6100
Toll Free: 1-877-263-5430 (1-877-CNF-KID0)
Email: jstone@childneurologyfoundation.org