2012 Us Group Annual Luncheon and Lecture

Provide Name (as you wish to be recognized in printed materials and name badges) Name/Organization: Contact: Street Address 1: Street Address 2: City: State: Zip Code: Phone: (No dashes 9046202875) E-mail Address: Please Select A Sponsorship Table: Click Here To View Sponsorship Underwriting Opportunities Underwriting Level Full Price Donation Presenter $30,000 ($29,150) Patron $15,000 ($14,640) Benefactor $7,500 ($7,180) Grand Host $5,000 ($4,720) Host $2,500 ($2,260) Friend $1,500 ($1,300) Table Underwriter $400 ($200) Exhibitor $200 *see Underwriting Opportunities I wish to decline the benefits associated with my gift and receive the full amount of tax deductibility Please select payment option: My Check is being mailed (please make check payable to the UNF Ticket Box Office). Mail check to: University of North Florida Ticket Box Office, Building 8, Room 1100 1 UNF Drive, Jacksonville FL 32224. Please call the UNF Ticket Box Office to make credit card reservations (904) 620-2878 Please list the names of all attendees at your table: Name: Name: Name: Name: Name: Name: Name: Name: Name: Name: Name: Name: Name: Name: Name: Name: Additional Comments: