MENU
Home
About Us
reservations
Contact Us
3.18.20
Dezerland Park
14401 NE 19th Avenue
North Miami, FL 33181
VIEW JOURNAL >>
-
Reservations
-
Thank you for your support of our KIDS.
The dinner is now over, but donations or pledge payments can still be made below.
You must have JavaScript enabled in order to use this page. Please enable JavaScript and then
reload
this page in order to continue.
Table Rates
Founders Hero´s Tribute
$18,000
Gala Sponsorship Packages
Partners Hero´s Tribute
$10,000
Benefactors Hero´s Tribute
$5,000
Patrons Hero´s Tribute
$2,500
Friends Hero´s Tribute
$1,800
Other Donation Amount $
Reservations
You are entitled to
complimentary reservations. Please select your reservations below.
Please reserve
-Select-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
dinner reservations at $360 per person.
Reservations above the
complimentary reservations are $360 each
I'm sorry I can't attend, but I want to help the children of Chai Lifeline.
Guest Names
Guest 1
Guest 2
Guest 3
Guest 4
Guest 5
Guest 6
Guest 7
Guest 8
Guest 9
Guest 10
Guest 11
Guest 12
Guest 13
Guest 14
Guest 15
Guest 16
Guest 17
Guest 18
Guest 19
Guest 20
Seating Preferences:
Ad Details
Ad Text:
Please use my ad from last year
Please tell us the name of the chairperson, committee member or Chai Lifeline contact who requested this contribution:
Total: $
Personal
Information
First Name:
*
Last Name:
*
Please display my name as
on the scroll.
Display my name as anonymous
Company Name:
Address:
*
City:
*
State:
*
:: Select One ::
Outside US & Canada
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territories
Nova Scotia
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
Zip Code:
*
Country:
*
United States
Albania
Algeria
American Samoa
Andorra
Anguilla
Antigua
Argentina
Aruba
Australia
Austria
Azores
Bahamas
Bahrain
Bangladesh
Barbados
Barbuda
Belarus
Belgium
Belize
Benin
Bermuda
Bolivia
Bonaire
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Canary Islands
Cayman Islands
Central Africa
Chad
Channel Islands
Chile
China
Christmas Island
Cocos Islands
Colombia
Congo
Cook Islands
Costa Rica
Croatia
Curacao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Ecuador
Egypt
El Salvador
England
Equitorial Guinea
Eritrea
Estonia
Ethiopia
Faeroe Islands
Fiji
Finland
France
French Guiana
Gabon
Gambia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea Bissau
Guyana
Haiti
Holland
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Ireland
Islands
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea
Kosrae
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Madeira
Malawi
Malaysia
Maldives
Mali
Malta
Martinique
Mauritania
Mauritius
Mexico
Micronesia
Monaco
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nepal
Netherlands
Nevis
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Ireland
Norway
Oman
Pakistan
Palau
Panama
Paraguay
Peru
Philippines
Poland
Ponape
Portugal
Puerto Rico
Qatar
Reunion
Romania
Rota
Russia
Rwanda
Saba
Saipan
Saudi Arabia
Scotland
Senegal
Seychelles
Sierra Leone
Singapore
Slovak Republic
Slovenia
South Africa
Spain
Sri Lanka
St. Barthelemy
St. Christopher
St. Croix
St. Eustatius
St. John
St. Kitts
St. Lucia
St. Maarten
St. Martin
St. Thomas
St. Vincent
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Tahiti
Taiwan
Tajikistan
Tanzania
Thailand
Tinian
Togo
Tonga
Tortola
Truk
Tunisia
Turkey
Tuvalu
Uganda
Ukraine
Union Island
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Gorda
Virgin Islands
Wake Island
Wales
Western Samoa
Yap
Yemen
Zaire
Zambia
Zimbabwe
Phone Number:
*
Cell Phone:
Email Address:
*
Payment
Details
Your card will be charged $
Card Type:
*
Visa
Mastercard
American Express
Card Number:
*
Exp. Month:
*
-- Select One --
01-January
02-February
03-March
04-April
05-May
06-June
07-July
08-August
09-September
10-October
11-November
12-December
Exp. Year:
*
-- Select One --
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
Security Code:
*
Comments:
Please mail a receipt to the address above
(in addition to the receipt I will receive via email).
Chai Lifeline Southeast is a non-profit 501c3 organization. Tax ID #11-2940331.
$110 represents the cost of the Gala for one person. The remainder of your contribution is deductible from income taxes to the extent permitted by applicable law.
Only enter this field if you were told to do so by a staff member.
© 2024 Chai Lifeline
Website by Duvys Media