Program Advertising Contract
All materials must be received by November 1, 2019. Business cards are acceptable. If not providing materials, please attach copy.
Name/Company _____________________________________________
Address ___________________________________________________
City/State/Zip ________________________ Telephone __________________
Email _______________________
I cannot attend, enclosed is my contribution for _______________________________
Visa/MC Account Number___________________________________
Expiration Date ___________
Amount to be billed to card _____________
Type of ticket(s) ________________
Number of Tickets __________
Signature _____________________________________________
Please make your check payable to The Jane Elissa Endowment Fund and mail to:
Jane Elissa Meyers
500 West 43rd Street, Suite 10F
New York, NY 10036
917-325-1085
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