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Sunday, October 15, 2017 Bel Air Bay Club, 16801 Pacific Coast Hwy., Pacific Palisades 5:30 P.M. VR Bar | 6:00 P.M. Buffet Dinner & Program ©2017 Common Sense Media ⎕ YES, I/WE ARE INTERESTED IN SPONSORING THE EVENT AT THE FOLLOWING LEVEL: Send registration form to: ⎕ Online: www.commonsensemedia.org/la-dinner-2017 ⎕ Check is enclosed (please make payable to Common Sense). ⎕ Invoice: Send to sponsor contact listed above. ⎕ Credit card: ⎕ Visa ⎕ MasterCard ⎕ American Express Amount: $ Name on card Card number Exp. date CCV Billing address: ⎕ Same as above Street City State ZIP Signature (required) Payment Options * AMEX 4-digit # on front, VISA/MC 3-digit # on back Contact name Title Company Street City State ZIP Phone ( ) Fax ( ) Email (required) Please indicate how name(s) should appear for sponsor recognition purposes: Sponsor Information HERO • $5O,OOO • 12 event tickets – premier reserved seating • Logo/name recognition on all event materials, social media promotion • Full-page ad in event journal • Provides funds for 100,000 LA students to receive our gold-standard digital citizenship curriculum ADVOCATE • $25,OOO • 10 event tickets – priority reserved seating • Logo/name recognition on all event materials, social media promotion • Full-page ad in event journal • Provides funds for a local school district to receive in-person training and hands-on support for deep implementation of Common Sense programs LUMINARY • $1O,OOO • 8 event tickets – preferred reserved seating • Logo/name recognition on all event materials, social media promotion • Underwrites the development of an online “teaching with tech” training course for local educators ENTREPRENEUR • $5,OOO • 6 event tickets • Logo/name recognition on all event materials • Supports the creation of a lesson plan on news literacy for LA students TUTOR • $2,5OO • 4 event tickets • Logo/name recognition on all event materials • Provides funds for 25 local educators to attend a training on a topic like cyberbullying PATRON • $1,25O • 2 event tickets • Name recognition on all event materials INDIVIDUAL TICKET • $375 Sponsor Levels ⎕ HERO $5O,OOO ⎕ ADVOCATE $25,OOO ⎕ LUMINARY $1O,OOO ⎕ ENTREPRENEUR $5,OOO ⎕ TUTOR $2,5OO ⎕ PATRON $1,25O ⎕ INDIVIDUAL TICKET $375: Qty. ⎕ I cannot attend but wish to make a donation: $ * Please note: Fulfillment through a Donor-Advised Fund prohibits the receipt of any goods or services in exchange for donation, including event tickets. Print deadline for invitation recognition: August 15, 2017. Print deadline for journal recognition: September 18, 2017. Email: Lisa Solomon — [email protected] For more information, please contact Lisa Solomon at 310-689-7536. Mail: Common Sense Attn: LA Dinner 2017 650 Townsend Street, Suite 435 San Francisco, CA 94103 Common Sense Media is a 501(c)(3) charitable organization (FEIN 41-2024986). All donations are tax-deductible to the extent allowable by law. Fair market value is $125 per ticket; tickets are nondeductible for tax purposes. Sponsorship Registration Form AN EVENING WITH THOMAS L. FRIEDMAN AND COMMON SENSE 2017 Los Angeles Dinner
