Jewels in the Night

Patient Care Division Gala

Saturday, January 18, 2014

The Albany Marriott

Proceeds from the event will be shared equally between capital improvements at Albany Memorial and the Troy Master Facilities Plan (MFP) for Samaritan and St. Mary’s Hospitals.

First Name Last Name Title Company Name
Address City State Zip
E-Mail Phone Fax
SPONSORSHIP
Company Name & Logo on favors
Company Name & Logo on banners to be hung in all three hospitals
Company Name & Logo in Times Union ad
Company Name & Logo on our websiteFull page ad (5.25”x 7.75”) in event program
Company Name & Logo on the invitation
Table of Ten
Company Name & Logo on banners to be hung in all three hospitals
Company Name & Logo in Times Union ad
Company Name & Logo on our website
Full page ad (4.75”x 7.75”) in event program
Company Name & Logo on the invitation
Table of Ten
Company Name on banners to be hung in all three hospitals
Company Name in Times Union ad
Company Name on our website
1/2 page ad (4.75”x 3.75”) in event program
Company Name on the invitation
Table of Ten
Company Name on banners to be hung in all three hospitals
Company Name in Times Union ad
Company Name on our website
1/4 page ad (2.25” x 3.75”) in event program
Company Name on the invitation
Table of Ten
Company Name in Times Union ad
1/4 page ad (2.25” x 3.75”) in event program
Company Name on the invitation
Table of Ten
HONORARY COMMITTEE
 Number of Tickets
To be included in the invitation, please return this response before November 8, 2013.
To be included in the program please return this response before November 29, 2013.
Your tax-deductible donation is the amount over $60 per reservation.
Attendance
Please charge my credit card for the following amount $
Card Type Card # Expiration Date (MM/YY) Signature
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St. Peter's Health Partners
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St. Peter's Health Partners
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