GALA Patron Ticket $750 GALA Patron Ticket Quantity(Required) Price: $750.00 Quantity $625.00 tax deductible amount per $750.00 ticketTotal First and Last Name(s)(Required) Seating Preference(Required) Please have the committee seat me/us. Please seat me/us at a hosted table. I/we am hosting a table. Table host's name If you are the table host, please input your last name.List of table matesEmail address(Required) Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Payment Method-AMEX, DISCOVER, MASTERCARD, VISA accepted*Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name
