event details
honoree
host
accommodations
sponsors
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* Required Field

Name*
Company
Address
City
State
Zip
Country
Phone (home)*
Phone (work)
Fax
E-Mail*

I am a pancreatic cancer survivor


I/We cannot attend the event, but would like to make a tax deductible donation:   $


Sponsorships
Please fill out Guest Names below

$100,000 - Presenting sponsor
  • Three premiere tables of ten at the gala
  • Top billing in all event press and collateral materials
  • Recognition as presenting sponsor on jumbo screen at event
  • Two panel Presenting Sponsor ad in Tribute Journal
  • Acknowledgement in The Pancreatic Cancer Action Network Newsletter
  • Prominent feature on Pancreatic Cancer Action Network website through November 2008
  • Major contributor recognition in annual report
  • Corporate logo featured on logo wall
  • Recognition on event invitation
$50,000 – Platinum sponsor
  • Two premiere tables of ten at the gala
  • Top billing in all event press and collateral materials
  • Two panel Platinum Sponsor ad in Tribute Journal
  • Acknowledgement in quarterly Pancreatic Cancer Action Network Newsletter
  • Prominent feature on Pancreatic Cancer Action Network website through November 2008
  • Major contributor recognition in annual report
  • Corporate logo featured on logo wall
  • Recognition on event invitation
$25,000 – Gold sponsor
  • One premiere table of ten at the gala
  • Recognition as a Gold sponsor on the jumbo screen
  • Gold Page in the Tribute Journal
  • Acknowledgement in The Pancreatic Cancer Action Network Newsletter
  • Prominent feature on Pancreatic Cancer Action Network website through November 2008
  • Major contributor recognition in annual report
  • Corporate logo featured on event signage
$10,000 – Silver sponsor
  • One preferred table of ten at the gala
  • Recognition as a Silver Sponsor on the jumbo screen
  • Silver Page in the Tribute Journal
  • Major contributor recognition in annual report
$5,000 – Bronze sponsor
  • One preferred table of ten at the gala
  • Recognition as a Bronze Sponsor on the jumbo screen
  • Full Page in the Tribute Journal
  • Major contributor recognition in annual report
$3,500 – Benefactor
  • One table of ten at the gala
  • Recognition as a Table Host on the jumbo screen
  • Full Page in the Tribute Journal
$1,250 – Friend
  • Two dinner tickets
  • Full Page in the Tribute Journal

$350.00 – Supporter Tickets
Number of tickets: Total





Guests at my table: (Please include yourself)
1. 6.
2. 7.
3. 8.
4. 9.
5. 10.


Tribute Journal
Location and size Quantity Price each Total
Back Cover
(5.5" x 7.0")		 $20,000
Inside Cover(s)
(5.5" x 7.0")		 $10,000
Platinum Page
(5.5" x 7.0")		 $5,000
Gold Page
(5.5" x 7.0")		 $3,000
Silver Page
(5.5" x 7.0")		 $2,000
Full Page
(5.5" x 7.0")		 $1,000
Half Page
(5.5" x 3.375")		 $500
Quarter Page
(2.625" x 3.375")		 $300
In Memory of $100
Please provide name:
Date of birth:
Date of passing:
In Honor of $100
Cancer survivor's name:


Order Total
Sponsorships/Tickets
Tribute Journal
No Charge for Survivor (one individual dinner ticket) (-)

Grand Total


(Please click the UPDATE button and verify the total)

Payment Method
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Amex
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Credit Card No.     Exp. Date
CSC Number What is CSC?



Billing Information

Name on Credit Card
Billing Address
Same as shipping address
Street Address
City
State
Zip Code
Country
Comments
v.052008