2
60th Anniversary Q-8 Company Dinner Saturday, 20 April 2013 Response Form 5 I/We will attend. Name______________________________ Pledge Name _______________________ Hofstra Year(s) of Graduation ____________________ Pledge Year __________________ Home Address ________________________________________________________ City ________________________________________ State _____ ZIP ___________ Home Phone _____________________ Email ________________________________ Guest(s) Name(s) _______________________________________________________ Guest(s) Hofstra Year(s) of Graduation _________________________________________ PAYMENT INFORMATION: If you pay at the door the night of the event, the cost is $70 per person. Register online and enter to win the 50/50 raffle at hofstra.edu/Q8Dinner2013. 5 Yes, I would like to become a lifetime member. My membership form with payment is enclosed. My dinner will be complimentary. 5 Yes, I am becoming an annual member for 2013 and will receive a $15 discount to the dinner. My 2013 membership and dinner are $95. My membership form with payment is enclosed. 5 Enclosed is a check in the amount of $_________ for ____ guests @ $60 per person. (Please make checks payable to Hofstra University; Memo: Q8AA.) 5 I would like to participate in the 50/50 raffle. Winner need not be present to win.* 4 Enclosed is a check of $________ for ______ raffle ticket(s), at $20 per ticket. 4 I prefer to pay by credit card, please see below. (Please add amount to the total below) 5 I would like to make a 100% tax-deductible donation to the Q8AA. 4 Enclosed is a check in the amount of $_________. 4 I prefer to pay by credit card, please see below. (Please add amount to the total below) 5 I prefer to pay by credit card. (Circle one.): Visa w MasterCard w American Express 4 Personal Card 4 Business Card Total amount $_________ (minimum $25) Credit card number___________________________________ Exp. date ___________ Name of cardholder (Please print.) ____________________________________________ Signature ____________________________________________________________ 39190:1/13 *Winner is required to complete an IRS Form W-9 to receive winnings.
