Czech Center Museum Houston

Sixteenth Annual Benefit Gala

A Night of Music, Dinner, Dance and Auction – August 28, 2010

Name__________________________________________ Address____________________________________________

City _____________________________ State  __________ Zip______________ Tel/Cell __________________________ 

Email: _____________________________________________

Underwriters enjoy preferred seating and special recognition - I wish to make the following reservations:

                    Tables of Ten            Individual                    

Platinum          $25,000                     $2,500                                             

Silver              $3,000                        $300

Garnet            $2,000                        $200

Reservation/s Reserved Seating @ $200.00 $______

Patron Reservation/s Open Seating @  $150.00 $______

Unable to attend but wish to make a contribution in the amount of $________________________

To book a reservation please call 713-528-2060

Please reply before August 14, 2010 – This e-mail address is being protected from spambots. You need JavaScript enabled to view it – www.czechcenter.org

Contributions tax-deductible as allowable by law.  For tax purposes, fair market value is $75.00 per person.

Incorporated in Texas as a 501[c][3] Non-profit Educational Cultural Arts Organization. EIN 76-0496649