A Tribute to Fashion Registration presents Tribute to Fashion Registration Name of Guest - Table of 10: If possible, please seat me with Please list all guests Restrictions or allergies The 25 Club in an independent non-profit 501 (c)(3). A copy of the official registration and financial information may be obtained from the PA Dept of State toll-free 1-800-732-0999. Your tax-deductible portion of each reservation is $61.50. Number of tickets at $150 each I wish to purchase raffle tickets - $25 each or 3 or $50 I wish to make a 100% tax deductible donation to the 25 Club of UPMC Magee-Womens Hospital in the amount of Choice of entree Gerber Chicken Virginia Spots Vegetarian Total amount (Payable to: The 25 Club of UPMC Magee-Womens Hospital) I would like to pay using PayPal Please charge my AMEX Visa Mastercard Name * Email * Phone * Address * Address Address Address City City State Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State Zip Zip Credit Card Account Number Expiration Date CSS Reservations will be held at the door. For more information: Contact Judy Woffington 412.741.4249 or Dani Grego 412.367.1426. reCAPTCHA If you are human, leave this field blank. Submit
