Encyclopædia Iranica, Gala 2004

Saturday, November 13, 2004

Response form- Event tables and tickets
Name
(Print clearly for listing purposes)
Title
Company (Print clearly for listing purposes)
Street Address
City
State
Zip
Phone (include area code)
Fax (include area code)
email
I am delighted to support the 2004 Encyclopædia Iranica Gala. Please note my contribution level below:
Pink Diamond: $500,000
Diamond: $300,000
Ruby: $100,000
Emerald: $50,000
Sapphire: $25,000
Topaz: $10,000
Garnet: $5,000
Individual Ticket $350
Contributor: I am unable to attend but wish to make a fully tax deductible contribution of $
 
My payment is enclosed will follow
 
Please make your check payable to the "Encyclopædia Iranica Foundation"


Check here if you do not wish to be listed in event materials.
Encyclopædia Iranica Foundation is a 501 (c) (3) non-for-profit organization, tax Id# 13-3636524.
Contributions are tax deductable in the extent they exceed the value of benefits provided.