Virginia Treatment Center for Children

Butterfly Ball - Fourth Annual Child Mental Health Gala

The Dominion Club

Friday, October 1st, 7 p.m. until 11 p.m.

To Register Online, click here.

To pay by check or credit card, please print and fill out this form and mail to address below.

 

MAKE YOUR RESERVATIONS TODAY

 

£      Event Ticket –   $100 each  

            Number of tickets ________

£      Monarch Sponsorships - $10,000

            20 tickets to the Butterfly Ball

            Recognition at the Event

£      Painted Lady Sponsorships - $7,500

            12 tickets to the Butterfly Ball

            Recognition at the Event

£      Swallowtail Sponsorships - $5,000

            8 tickets to the Butterfly Ball

            Recognition at the Event

£      Peacock Sponsorships - $2,500

            4 tickets to the Butterfly Ball

            Recognition at the Event

£     Skipper Sponsorships - $1,000

            2 tickets to the Butterfly Ball

            Recognition at the Event

 

£      Gift I/We are unable to attend, but have enclosed a contribution in the amount of         $_______________.

 

For more information please contact Delores Richards-Madikiza at 804.828.1123 or drichards-madikiza@mcvh-vcu.edu

 

NOTE TO SPONSORS:  Information must be received by September 10, 2010 to be included in the program.

 

Name: ________________________________________________________________________

 

Sponsor Name for Program: ____________________________________________________

 

Address: _______________________________________________________________________

 

City/State/Zip:   ________________________________________________________________

 

Telephone (Day/Evening): ______________________________________________________

 

Email_____________________________________________________________

 

Payment Options:

 

Check for $_________________ (Please make checks payable to: VTCC Advisory Council)

 

1 VISA     1 MasterCard   Card Number________________________________________________   

Exp. Date _____________

 

Name on Account___________________________________________________________________

 

Signature_____________________________________________________________________________

Thank you for your support!  $25 of each ticket is tax deductible.

 

Advisory Council of the Virginia Treatment Center for Children
800 E. Leigh Street, Suite 150
  Richmond, VA 23219

www.virginiakids.net

Tax ID # 52-1586450

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