Professional Documents
Culture Documents
Somos Sponsorship Levels Spring 2012
Somos Sponsorship Levels Spring 2012
Friday, March 23rdSunday, March 25th, 2012 CHAIRMAN NYS ASSEMBLY PUERTO RICAN/ Albany, New York HISPANIC TASK FORCE
FELIX W. ORTIZ
Additional Gala Tickets Reserve ____ Ticket (s) for $250.00 each Total:_______________ Contact Information Name: __________________________________________________ Title: ___________________________________________________ Company: _______________________________________________ Address: ________________________________________________ ________________________________________________________ Phone: _______________________ Fax: ______________________ Contact Name: ___________________________________________ Email: __________________________________________________ Amount: $_____________ Credit Card: Visa Amex MC
#_______________________________________________________ Exp. Date: _______________ Sec. Code: ___________ Name of cardholder:______________________________________ Billing address: __________________________________________ Billing zip code: __________________________________________ I have enclosed a check in the amount of: $___________________ PLEASE RETURN THIS FORM WITH PAYMENT TO: Somos Inc. P.O. Box 378 Warwick, NY 10990 For more information, please contact: Stephanie Rodriguez Tel/Fax: 518-380-6003 Email: somosconference@gmail.com
All 2012 Conference sponsorship levels support the Somos Scholarship Fund