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Black-tie, RSVP required.
If you have questions, please contact us at:
(415) 472-2373, ext. 305 or
Lifehouse

To make reservations, complete this form and submit on-line or print it out and mail it to the address below.

We will confirm receipt of your reservation.

 Name
(Individual or Company)
 

Each table and sponsor category will have a separate listing in the evening's program.



"Preferred seating will be given according to levels of purchase"
  Contact Name  
 Address  
 City,State, Zip
 Telephone  
 E-mail  
Please reserve the following for me:
   Platinum Table for ten at $3,500

 Payment Options

Please call me for my credit card information

My check for

will be sent separately to:

Lifehouse
18 Professional Center Parkway
San Rafael, CA 94903

   Gold Table for ten at $3,000
   Silver Table for ten at $2,500
  Number of sponsor tickets at $250.
  Number of individual tickets at $175.
       THANK YOU!