CICBVI Presents 2nd Annual Dinner in the Dark -- Sponsor Registration
Date: Sunday, October 13th, 2019
Time: 5:30 p.m.
Location: The Warehouse on State (736 SW Washington, Peoria, IL)
Sign in to Google to save your progress. Learn more
Your Sponsorship is CRUCIAL to the Center's Success!
Email Address: *
Company (Please list name as you would like it to appear in the event program): *
Name: (Last, First) *
Street Address: *
City: *
State: *
Zip Code: *
Phone Number: *
Level of Sponsorship: *
Meal Choice: *
Please list any dietary restrictions below (e.g. gluten-free, nut-free): *
Comments:
Payment Method: *
Please make check payable to "CICBVI" and send to:
Central Illinois Center for the Blind and Visually Impaired (CICBVI)
2905 W Garden St
Peoria, IL 61605

*Once payment is received, a receipt will be emailed to you or a printed receipt will be given to you the night of the event.
Paying using our PayPal account? Here's how:
*An online service fee of 3.00% will be added to your registration fee.
*A receipt will be emailed to you

1. Click this link: www.cicbvi.org/2019-dinner-in-the-dark-sponsor-online-payment
2. Select the number of tickets you would like to purchase from the drop down menu.
3. "Add to Cart" and pay using PayPal or your credit/debit card.
Questions?
Contact Felisa Durr
309-637-3693
info@cicbvi.org

OR

Darlene Violet
309-240-8597
groovym2@aol.com
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy