Jewels in the Night

Patient Care Division Gala

Saturday, January 7, 2017 at 6:30pm

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 website
Full page ad (4.75Wx7.75L) in event program
Company name & logo on the invitation
Table of 10
Company name & logo on banners hung in all three hospitals
Company name & logo in Times Union ad
Company name & logo on our website
Full page ad (4.75Wx7.75L) in event program
Company name & Logo on the invitation
Table of 10
Company name on banners hung in all three hospitals
Company name in Times Union ad
Company name on our website
1/2 page ad (4.75Wx3.75L) in event program
Company name on the invitation
Table of 10
Company name on banners hung in all three hospitals
Company name in Times Union ad
Company name on our website
1/4 page ad (2.25Wx3.75L) in event program
Company name on the invitation
Table of 10
Company name in Times Union ad
1/4 page ad (2.25Wx3.75L) in event program
Company name on the invitation
Table of 10
To be included in the invite, respond by 11/4/2016.
To be included in the program, respond by 12/12/2016.
HONORARY COMMITTEE
 Number of Tickets
Your tax-deductible donation is the amount over $60 per reservation.
How would you like to be listed on Gala materials?
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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