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So Cal Gala Registration Form
Nightlight SoCal Gala Anniversary Dinner
Saturday, April 30, 2022
The Oasis Event Center
801 Narcissus, Corona Del Mar, CA 92625
6pm to 9pm
Donation
Reservation
Catering Sponsor for $5000
Venue Sponsor for $2500
Teddy Bear Blitz Sponsor for $1000
Advertising Sponsor for $500
Table for 8 for $350
Child Tickets $20 each
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Adult Ticket $50 each (2 Free)
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Donor Information
Last Name
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First Name
*
Middle Name
Donor Address
Street Address
*
Street Address Line 2
City
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State/Region
*
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Enter Region
Zip Code
*
Donor Contact Info
Home Phone
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Home Email
*
Guests
Please list all guests in your party (if purchasing individual tickets) or at your table (if you are an event sponsor). You're not required to enter all your guests at this time. You can email us at
rebekah@nightlight.org
to register any remaining guests or make other changes.
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Payment Method
Payment Method
Credit Card
Check
*
Credit Card Billing Address
Address
*
City
State/Region
AK - Alaska
AL - Alabama
AR - Arkansas
AS - American Samoa
AZ - Arizona
CA - California
CO - Colorado
CT - Connecticut
DC - District of Columbia
DE - Delaware
FL - Florida
FM - Federated States of Micronesia
GA - Georgia
GU - Guam
HI - Hawaii
IA - Iowa
ID - Idaho
IL - Illinois
IN - Indiana
KS - Kansas
KY - Kentucky
LA - Louisiana
MA - Massachusetts
MD - Maryland
ME - Maine
MH - Marshall Islands
MI - Michigan
MN - Minnesota
MO - Missouri
MP - Northern Mariana Islands
MS - Mississippi
MT - Montana
NC - North Carolina
ND - North Dakota
NE - Nebraska
NH - New Hampshire
NJ - New Jersey
NM - New Mexico
NV - Nevada
NY - New York
OH - Ohio
OK - Oklahoma
OR - Oregon
PA - Pennsylvania
PR - Puerto Rico
PW - Palau
RI - Rhode Island
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VA - Virginia
VI - Virgin Islands
VT - Vermont
WA - Washington
WI - Wisconsin
WV - West Virginia
WY - Wyoming
*
Enter Region
Zip
*
Credit Card Information
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Credit Card Number
*
Credit Card Expiration Month
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2 - February
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8 - August
9 - September
10 - October
11 - November
12 - December
*
Credit Card Expiration Year
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2025
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2028
2029
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Credit Card Security Code
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