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Register Online!

by hong — last modified 2008-10-20 15:15

Thank you in advance for your support and generous contributions. We look forward to celebrating with you at the Gala!

VIP Reception Tickets

$250 each includes VIP Reception / Awards Ceremony / Jazz & Dessert Reception

Awards Ceremony Tickets

$75 each includes Awards Ceremony / Jazz Cocktail & Dessert Reception following ceremony

CALL 202-265-8280 FOR GROUP 10% DISCOUNT!

REGISTRATION

Please complete the form below. Be sure to check all entries for accuracy, including required fields and payment selection options, before submitting the form.

Personal Profile

*required field

First Name:
 *
Last Name:
 *
Company/Organization:
 *
Address:
 *

City:
 *
State:
*
Zip:
 *
Phone:
 *
Fax:
Email:
 *

 

Single Tickets

Subtotals
  • VIP Reception Tickets:
Tickets@$250 each
  • Awards Cememony Tickets:
Tickets@$75 each

 

Guests

Please list guests names, if your sponsorship includes more than 1 ticket.

 

Payment Method

- Credit card payments will be processed using PayPal.
- Checks should be made payable to “Banneker Insitute Project of Catalyst” and mailed to:

The Banneker Institute
Suite 201
1661 Park Road, NW
Washington , DC 20010

Registration for the Gala is not complete until payment has been received.

 

Total Due

Click the “Register Now” button below to complete registration.

An automated email containing the contents of this form will be sent to you after successful submission