Roundtable 30th Hon Com Resp Form

ALBANY ROUNDTABLE civic luncheon series PO Box 7101 • Albany, NY 12224 FOUNDED

1979 • WWW.ALBANYROUNDTABLE.COM

Honorary Committee Response Form th

Albany Roundtable 30 Anniversary Thursday, May 28, 2009 The University Club, 141 Washington Avenue, Albany 6:00 PM to 8:00 PM

Name(s): ____________________________________________________________________________ Business Name: ______________________________________________________________________ Address: ____________________________________________________________________________ Phone_______________________________ Email: ________________________________________

Please check all that apply:
YES, my business or organization will be a Corporate Sponsor


YES, I/we will be a member of the Honorary Committee (indicate number of tickets)

 Visionary Leader ...........................$3,000  New Urbanist .................................$1,000  Sustainability Partner ......................$ 500

 Patroon ..................................___ @ $200  Shaker ....................................___ @ $100  Knickerbocker ........................___ @ $ 50


NO, I cannot join the Honorary Committee, but wish to purchase ___ tickets at $30 each.

Total Enclosed: ................................................................................................................................

Please make check payable to “Albany Roundtable” and send with a copy of this form to: Albany Roundtable, PO Box 7101, Albany, NY 12224 All amounts in excess of $30 per ticket are tax deductible. For more information please visit www.albanyroundtable.blogspot.com .