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Tickets for 25th Anniversary Recognition Event

Please use the form below to order tickets for the 25th anniversary celebration. Can't attend but want to help out? Please visit our online donation page.

* Required

* First Name:
* Last Name:
* Phone:
* Email:

* Tickets:

Qty	Type	Cost Each
0 1 2 3 4 5 6 7 8 9 10	Tickets:	$50
0 1 2 3 4 5 6 7 8 9 10	Patron Tickets:	$100
0 1 2 3 4 5 6 7 8 9 10	Package of 8 Tickets:	$350
0 1 2 3 4 5 6 7 8 9 10	Package of 8 Patron Tickets:	$700
Total  $

* Payment Method:	-select- Visa Mastercard American Express
* Credit Card Number:
* Exp. Date:	Month: Year:
* Security Code:

Guest Names (all names held at door)

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Fact:

181,461 AIDS cases have been in New York - more than any other state.