2015 MEN OF DISTINCTION ANNUAL AWARDS LUNCHEON - WEDNESDAY, MAY 6, 2015 CHAIRMAN BOBBY TUDOR SPONSOR REPLY FORM Name: (please print your name as you wish it to appear on all printed materials) Address: City: State: Home Phone: Zip: Office Phone: Fax: Email: PLEASE RESPOND BY MARCH 20, 2015 TO APPEAR AS A SPONSOR IN PRINTED MATERIALS. I wish to support the 2015 Men of Distinction Annual Awards Luncheon at the following level: PRESENTING SPONSOR – $30,000 PARTNER – $25,000 BENEFACTOR – $15,000 SPONSOR – $7,500 BENEFACTOR COUPLE – $2,500 BENEFACTOR INDIVIDUAL – $1,500 INDIVIDUAL TICKET – $750 Or Please go to menofdistinction.org to support the event. I cannot make the event, but would like to support medical research: Support Medical Research (95% of your contribution goes to medical research) Enclosed is a check made payable to: MEN OF DISTINCTION OF GREATER HOUSTON Please charge my: Visa MasterCard AMEX Name on Card: Signature: Discover Card No.: _________________________________________ Expiration Date: _____________ CIV: By signing below, I pledge the amount indicated above to be paid in full by Tuesday, April 1, 2015. I understand that full payment must be received in order to receive the benefits of my sponsorship and that a signed form must be returned in order for Men of Distinction to accept my pledge commitment. (Pledge payment reminders will be sent in March.) Signature: Date: (Signature required for pledge commitments) I am unable to attend the event, but enclosed is my tax-deductible donation of $ This gift is: in honor of: in memory of: Name: Please notify the following person(s) of my honor/memorial gift: Name: Address: City: State: Zip: The value of the goods and services received will be included in your Official Gift Receipt. Please return this form by mail or fax to: Men of Distinction P.O. Box 130630 Houston, Texas 77219 • Telephone: 281-584-2219 • Fax: 281-584-2297 Men of Distinction is 501(c)(3) non-profit organization or dwuthrich@menofdistinction.org