Women Legislators Annual Opening Reception

Seizing the Challenge!

Tuesday, January 11, 2011

6:30 - 8:30 p.m.

Governor Calvert House

58 State Circle

Annapolis, Maryland

REGISTRATION FORM

There are two ways to register for this event:

OPTION ONE:
Payment via written check

1. FULLY COMPLETE THIS FORM.
2. Once complete, click PRINT FORM to print out a hardcopy for mailing
3. Make checks payable to, and mail completed form to:
      Women Legislators of Maryland Foundation, Inc.
      P.O. Box 1587,
      Annapolis, MD 21404-1587
4. Click SUBMIT. This will notify us of your registration.

OPTION TWO:
Payment online using your credit card

1. FULLY COMPLETE THIS FORM.
2. Click PAY WITH CREDIT CARD.
3. Follow online credit card payment procedure.

A reservation is made when payment is received.

Name of Company, Organization, or Individual:

Mailing Address:

Name of Contact Person:

Please select your desired sponsorship level:

$5,000 - PLATINUM Sponsors
Includes reserved table for ten, special recognition at event and in program.
Please list the names of your 20 guests here.

$2,500 - GOLD Sponsors
Includes reserved table for ten, recognition at event and in program.
Please list the names of your 10 guests here.

$1,250 - SILVER Sponsors
Includes 5 reservations, recognition at event and in program.
Please list the names of your 5 guests here.

$500 - BRONZE Sponsors
Includes 2 reservations, recognition at event and in program.
Please list the names of your 2 guests here.

$100 - INDIVIDUAL Reservation

All registration forms and payments

must be received by

December 15, 2010!

All checks should be made payable to:
Women Legislators of Maryland Foundation, Inc.
P.O. Box 1587
Annapolis, MD 21404-1587

For additional information:
Email: info@WomenLegislatorsMD.org

Phone: 410-693-1508