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 AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming 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 Submit
