Bid for Life registration form

Registration Form

Birthright of Chicago and
Illinois Right to Life Committee
41st Annual "Bid for Life"
Benefit Dinner
Friday, April 15, 2011
Cocktails 6 p.m. (cash bar), Dinner 7:30 p.m.
at Drury Lane
100 Drury Lane, Oak Brook Terrace, IL

Mr. & Mrs._____________________________________________________________

Address________________________________________________________________

City_____________________________ State_____________ Zip__________________

Telephone_______________________________________________________________

Please reserve ______ tickets ($75 donation per person or $600 for table of ten)
Tickets will be held at the door. Menu: _____Chicken or _____Fish

Enclosed is $______ for my enclosed raffle tickets. (Raffle tickets will not be sold at the event.)

We are unable to attend but wish to support your work with a $__________ donation.

I would like to donate the following to the Silent Auction: (give value of each item)

______________________________________________________________________

I may be contacted at _____________________ to arrange for pick-up of the above items.

I wish to be seated with:

______________________________________________________________________

Please make checks payable to Illinois Right to Life Committee
Mail to: 65 E. Wacker Place, Suite 800 • Chicago, IL 60601
R.S.V.P. by April 8, 2011
A portion of your contribution is tax deductible.