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Greer Garson Gala

benefiting

Women and Infant Services at Texas Health Presbyterian Hospital Dallas

Saturday, April 26, 2014    7 - 11:30 p.m.
Omni Dallas Hotel

Please complete the form below. A RED asterisk (*) denotes required fields. After completing all fields click on the Submit button. Note that all reservations will be held at the door.

If you are interested in sponsoring the Gala,
please click here to view our underwriting form.

 

Name of Individual: *  
 
Address: *
City: * State: *   Zip: *  
Phone: *
Fax:
E-mail: *


Purchase Tickets

Number of tickets to reserve at $200 each:
 

Please include the full name and phone number for yourself and the guests for whom you are purchasing tickets. This information is necessary to assign bid numbers for the silent auctions and charitable casino.

A table seats 10 guests.

Please indicate which guests you are purchasing tickets for by checking the box to the right of the contact information you enter. If you desire to sit with a guest(s), but are not purchasing their ticket(s), please submit their full name and phone number as well and check “Wish to be Seated with This Guest.” They will need to purchase their ticket through this site and list you as their seating preference, too.

On behalf of our patients and their families who will benefit from your generosity, thank you for your support of the Greer Garson Gala.
 
  Name Phone Purchasing Ticket For This Guest Wish to be Seated with This Guest (This Guest Will Purchase Their Own Ticket Separately)
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I/We will not be able to attend this year, but please accept my donation of $
 
 

Payment Information
*** Amount *  
*    Pay on-line
Card Type:
Please enter information below exactly as it appears on the credit card.

Cardholder Name: * 
Card Number: * 
Card Validation Code: *  What's this?
Expiration Date: * 
Billing Address         Billing address same as above.
Address: * 
City: * 
State * 
Zip: * 
** Payment to be received prior to April 26, 2014 **

Please enter authentication challenge words below and click Submit button only once.
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Texas Health Resources Foundation
Greer Garson Gala
612 E. Lamar Blvd. Ste 300
Arlington, Texas 76011

682-236-5234
LaniHancock@TexasHealth.org
TexasHealth.org/GreerGarsonGala

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