Annual Medicine Ball Fundraiser Faculty/Physician Sponsors

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Hello UT Community! Thank you for your generosity and willingness to donate items and/or sponsor department/student attendance at the 2024 UTCOMLS Medical Ball.

Please use this form to provide us with the details of your donation.

Note that one table seats 10 people.

This is the form for purchasing tickets/table(s) for your students, department, residents, etc. or for donating items to our auctions.

The deadline to purchase sponsored tickets is January 10th, 2024

Tickets include dinner + dancing for $60 or 1 table for $600.

If purchasing a ticket for yourself/personal guests to attend, please use the ticket & RSVP form.

The UTCOMLS Annual Medical Ball Fundraiser will take place on Saturday January 27th, 2024.

Click here for event information.

100% of the money raised by this event goes directly to patient care efforts at CommunityCare Clinics, global health outreach through Students for Medical Missions, and student mentorship & development programs through the American Medical Student Association.

First and last name of ticket buyer *

Department/title (ex: internal medicine UTMC)

UT/ProMedica email *

I am sponsoring/donating:

Table(s)

Tickets (not a full table)

Auction item

Clear selection

Number of DINNER + DANCING tickets I am purchasing ($60):

Number of TABLES (seats 10) I am purchasing ($600)

Please indicate the intended use of your tickets if you have a specific purpose/names in mind.

Ex: "I am sponsoring my Rocket Pod." or "Pediatrics Department."

Other sponsorship/donation:

If making a donation, please specify what it is below.

For tables & monetary donations: have you sent Eric Lassiter your payment details? *

I have sent Eric the payment via Zelle (preferred) phone # 919-452-3370 description: MedBall2024 Sponsor

I have sent Eric the payment on Venmo (description: MedBall2024 Sponsored Tickets)

I will contact Eric eric.lassiter@rockets.utoledo.edu to work out another payment option (check).

I am paying through the UT Foundation account - please still let Eric know.

For auction items, we will contact you to coordinate pick-up. Thank you!

I acknowledge that I will receive an e-mail from someone on the Medicine Ball Planning Committee.

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