LIUBA 2014 Registration Form

Gala options

Purchase Gala Tickets Sponsor Donor Volunteer (CLOSED) Attendee

Please check all applicable options

Please note that all Volunteer positions for the gala are filled. Feel free to share your contact details so that we can include you in next year's gala team! Perhaps you would consider the option to Purchase Gala Tickets for this year's event?

Contact details

First name*

Last name*

Phone number*

Email address*

Title

Organization

Mailing address*

Mailing city*

Mailing state/province*

Mailing zip/postal code*

Mailing country*

Sponsor details

Package*

Sponsor gala tickets*

Sponsor gala ticket price

NonSponsor gala ticket price

Please note:

If you don't yet know the name of an attendee, then please enter TBA TBA or something similar to let us know that you'll be providing that important information closer to the event.
Mobile Phone and Email Address for each attendee are not required at this time; but will be extremely helpful to shorten the lines at check-in and are highly recommended.

First sponsor attendee

First Name

Last Name

First sponsor mobile phone

First sponsor email address

Second sponsor attendee

First Name

Last Name

Second sponsor mobile phone

Second sponsor email address

Third sponsor attendee

First Name

Last Name

Third sponsor mobile phone

Third sponsor email address

Fourth sponsor attendee

First Name

Last Name

Fourth sponsor mobile phone

Fourth sponsor email address

Fifth sponsor attendee

First Name

Last Name

Fifth sponsor mobile phone

Fifth sponsor email address

Sixth sponsor attendee

First Name

Last Name

Sixth sponsor mobile phone

Sixth sponsor email address

Seventh sponsor attendee

First Name

Last Name

Seventh sponsor mobile phone

Seventh sponsor email address

Eighth sponsor attendee

First Name

Last Name

Eighth sponsor mobile phone

Eighth sponsor email address

Donor details

Amount* $

Supporting

Light It Up Blue Aspen Valley Autism Assistance Fund

Additional instructions

If you have any preferences for how you might want your donations to apply, then please specify them here.

Attendee details

Gala tickets*

$250 each

Please note:

If you don't yet know the name of an attendee, then please enter TBA TBA or something similar to let us know that you'll be providing that important information closer to the event.
Mobile Phone and Email Address for each attendee are not required at this time; but will be extremely helpful to shorten the lines at check-in and are highly recommended.

First attendee*

First Name

Last Name

First mobile phone

First email address

Second attendee*

First Name

Last Name

Second mobile phone

Second email address

Third attendee*

First Name

Last Name

Third mobile phone

Third email address

Fourth attendee*

First Name

Last Name

Fourth mobile phone

Fourth email address

Fifth attendee*

First Name

Last Name

Fifth mobile phone

Fifth email address

Sixth attendee*

First Name

Last Name

Sixth mobile phone

Sixth email address

Seventh attendee*

First Name

Last Name

Seventh mobile phone

Seventh email address

Eighth attendee*

First Name

Last Name

Eighth mobile phone

Eighth email address

Ninth attendee*

First Name

Last Name

Ninth mobile phone

Ninth email address

Tenth attendee*

First Name

Last Name

Tenth mobile phone

Tenth email address

Eleventh attendee*

First Name

Last Name

Eleventh mobile phone

Eleventh email address

Additional details

Comments

Payment details

Total

Payment type*

Credit card details

Billing address*

Billing city*

Billing state/province*

Billing zip/postal code*

Billing country*

Card number*

Card expiration date*

Card verification code*

* Office Use Only *

Check number

Check deposit date

Special comments

Invoicing details

Please note that invoices will be processed manually and that confirmations/receipts will be generated only after payment has been received and processed.

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Gala options

Contact details

Sponsor details

Donor details

Attendee details

Additional details

Payment details

Credit card details

*** Office Use Only ***

Invoicing details

* Office Use Only *