Registration, Advertising and Sponsorship Form

Shades of Autumn
North East Westchester Special Recreation, Inc.
Ninth Annual Dinner Dance
Saturday, November 5, 2016
The Fountainhead in New Rochelle
COCKTAILS 7PM • DINNER, DANCING AND SILENT AUCTION 8PM
In the past, the funds raised at this gala have allowed us to build an addition at our Bradhurst facility to
improve upon our program and office space, assisted us in keeping our program fees affordable for our
families, and helped us to manage our budget despite the imposed transition to Medicaid Waiver.
Sponsorship Packages
Name as you would like it to appear in print
Organization
Pacesetter $10,000
• Twenty Tickets
• Journal Cover Selection
• Name and/or Company Listed
Prominently in Program
Supporter $7,500
• Ten Tickets
• Two Gold Pages in Journal
• Name and/or Company Listed
Prominently in Program
Address
Benefactor $5,000
• Ten Tickets
• Gold Page in Journal
• Name and/or Company Listed
Prominently in Program
City, State, Zip
Phone
Email
Total amount enclosed: $________________________
Charge my: n MC n Visa
Patron $3,000
• Ten Tickets
• Silver Page in Journal
• Name and/or Company Listed
Prominently in Program
Sponsor $1,000
• Four Individual Tickets,
• Full White Page in Program
Contributor ____ at $250 $_______
Card #
• Event Ticket
• Name Listed in Program
Name on card
Exp. Date
Two Tickets ____ at $350 $_______
Security Code
Individual
Ticket(s)
____ at $180 $_______
Journal Advertising
n
n
n
n
n
n
n
Gold Page
Silver Page
White Page
Half Page
Quarter Page
Business Card Ad
Booster Ad
$2,500
$1,500
$500
$300
$150
$100
$50
Journal Ad Sizes:
Full Page 7.5w x 10h
Half Page 7.5w x 5h
Quarter Page 3.75w x 5h
Sponsorships and Ad Copy Due
October 4, 2016
Send artwork in jpg or pdf format to:
jriley@northeastspecialrec.org
Checks made payable to:
North East Westchester
Special Recreation, Inc.
63 Bradhurst Avenue
Hawthorne, N.Y. 10532
For further information contact:
Janet Riley (914) 347-4409
jriley@northeastspecialrec.org
Contribution
Although I am not able to attend,
I wish to support North East by
making a tax deductible contribution
in the amount of $______________.
North East Westchester Special Recreation, Inc.
provides therapeutic recreation for children and adults with developmental disabilities in Westchester County.
Visit us at: www.northeastspecialrec.org