RCLA TOWN HALL 2017

SUBSCRIPTION REQUEST FORM

ALL SUBSCRIPTION REQUESTS MUST BE

MAILED. SEATING SELECTION IS BASED
ON EARLIEST POSTMARK DATE.
The following Member levels and allowed
subscriptions will be followed when fulfilling
all orders:

Friend Maximum 2 subscriptions

Supporter Maximum 4 subscriptions

Patron Maximum 4 subscriptions

Lifetime Maximum 4 subscriptions

SUBSCRIPTION INFORMATION:
941.925.1343
www.RCLAssociation.org

SECTION

PRICE
Per Series
Subscription

PLATINUM
Invitation to complimentary Platinum Appreciation Dinner

$700

Dinner invitations are limited to Platinum ticket holders and

are non-transferable.
Preferred seating in Platinum section

MORNING
Lecture series quantity
(Limit 4)

EVENING
Lecture series quantity
(Limit 4)

$175.00
Taxable
Deduction, 2016

One (1) ticket for each of five (5) lectures

GOLD
One (1) ticket for each of five (5) lectures

$450
$112.50 Taxable
Deduction, 2016

SILVER
One (1) ticket for each of five (5) lectures

$350
$87.50 Taxable
Deduction, 2016

BRONZE
One (1) ticket for each of five (5) lectures

$300
$75.00 Taxable
Deduction, 2016

SUBSCRIPTION REQUEST TOTAL $

LUNCHEON RESERVATIONS

Luncheons are held in the Van Wezel's Grand

Foyer immediately following each morning lecture.

QTY

TOTAL

Dick Cheney

Monday, January 23, 2017

$35 each

Geena Davis

Monday, February 13, 2017

$35 each

Jared Cohen

Monday, February 20, 2017

$35 each

James Balog

Monday, March 6, 2017

$35 each

Kofi Annan

Wednesday, March 22, 2017

$35 each

EVENING DINNER | RECEPTION RESERVATIONS

Supper by the Bite will be served before each evening lecture
and a speaker reception with dessert will be held after each
lecture for one price.

QTY

TOTAL

Dick Cheney

Monday, January 23, 2017

$40 each

Geena Davis

Monday, February 13, 2017

$40 each

Jared Cohen

Monday, February 20, 2017

$40 each

James Balog

Monday, March 6, 2017

$40 each

Kofi Annan

Wednesday, March 22, 2017

$40 each

If your requested seats need to be in accessible seating,

please indicate ______ # of seats

Subscription Request Total $

Luncheon/Reception Total $
Additional Dontation $
Total Amount Enlosed $
*Please turn over the subscriber form to fill out payment information

METHOD OF PAYMENT
Personal Check

(U.S. funds only, payable to RCLA TOWN HALL 2017)

Visa

MasterCard

Discover

Account Number
Expiration Date

3-Digit Security Code

Billing Zip Code

Signature
In November, mail my tickets to (please print):
First Name

Last Name

Address
City
State
Phone

Zip Code

Sarasota Area Phone

Email
PLEASE PROVIDE YOUR EMAIL TO RECEIVE
CONFIRMATION RECEIPT OF YOUR SUBSCRIPTION
MAIL SUBSCRIPTION REQUEST TO:
RCLA TOWN HALL 2017
P.O. Box 814
Sarasota, FL 34230-0814