WBASNY
1/21/14
WBASNY BOARD MEETING SPONSORSHIP ORDER FORM
Name
Firm (if applicable)
Address
City
State
Zip
Telephone
Fax
E-mail address
�
YES
, I / We are pleased to sponsor a WBASNY Board meeting as indicated below:
�
Meeting
�
September (New York, NY)
�
November (Albany, NY)
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January (New York, NY)
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March (New York, NY)
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Committee Meeting
$ 50.00
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Marketing Materials
$ 250.00
�
Breakfast
$ 500.00
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Lunch
$ 500.00
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Board Meeting
$ 500.00
Method of Payment
�
Enclosed is a check made payable to: WBASNY
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Please charge my/our credit card:
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Amex
�
MC
�
Visa
__________________________________________
__________/__________
Card Holder Name
Expiration Date
__________________________________________
__________
Account Number
CVS#
______________________________________________________________________________
Billing Address, City, State, Zip
___________________________________________________________
Cardholder Signature
Please return order form, payment and advertisement to:
Women’s Bar Association of the State of
New York,
Post Office Box 936, New York, NY 10024-0546
