MLK Awards
Registration Form
YES
, our company is proud to participate in the Martin Luther King, Jr. Business Social Responsibility Awards luncheon on Friday,
January 18, 2013
at the
MARRIOTT CITY CENTER HOTEL, 1701 California Street
.
Attendance Type
*
Individual seating $75/each (Bonus: $65 if reserved by December 7th)
Bronze Sponsor table $1,500 ten seats (Bonus: $1,300 if reserved by December 7th)
Silver Sponsor table $2,000 ten seats (Bonus: $1,800 if reserved by December 7th)
Gold Sponsor Table $2,500 ten seats (Bonus: $2,300 if reserved by December 7th)
How many seats would you like?
*
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
I would like to donate 2 seats at my table for VIP guests.
Yes
No
Companies who purchase a Gold Sponsor table will receive first priority seating at the luncheon, recognition in the luncheon program booklet and special acknowledgement from the podium. Silver Sponsors will receive priority seating at the luncheon and recognition in the program booklet. Deadline for reservations is
Tuesday, January 4, 2013.
Remember, this event sells out early every year.
Advertising in the program booklet will support scholarship programs for minority students. Please submit your camera-ready black and white artwork to the address below, or email a digital file to straight@usa.net no later than
Friday, December 28, 2012.
Advertising Options
Business card (3 3/4” wide x 2 1/2” high) $100
Half-Page (7 1/2” wide x 5” high) $1,500
Full-Page (7 1/2” wide x 10” high) $2,000
Donation:
If you are unable to attend this event, or would like to contribute an additional amount to support scholarship programs for minority students, we would graciously accept your donation.
Company Information
Name
*
First
Last
Company
*
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
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California
Colorado
Connecticut
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District of Columbia
Florida
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Idaho
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Louisiana
Maine
Maryland
Massachusetts
Michigan
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Mississippi
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Montana
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New Hampshire
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New York
North Carolina
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Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
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West Virginia
Wisconsin
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Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip Code
Email
*
Enter Email
Confirm Email
Phone
*
Fax
Additional Notes
Payment Information
Payment type
Check
Credit Card
Make checks payable to: Business Social Responsibility Awards Luncheon.
Mail Checks and Advertising Art Work to:
MLK Reservations, c/o Andavo Meetings
6430 S. Fiddler's Green Circle, Suite 220
Greenwood Village, CO 80111
Name on card
*
First
Last
Card type
*
American Express
Discover Card
Mastercard
Visa
Card number
*
Expiration month
*
January
February
March
April
May
June
July
August
September
October
November
December
Expiration year
*
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
CVC code
*
4 didgit code for AMEX / 3 digit code for all others
Billing Address
*
Same as above
Enter Billing Address
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip Code
If your registration payment will be processed by credit card, your credit card statement will read Andavo Meetings & Incentives.