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PATIENT PORTAL
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712-722-1700
877-722-1770
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care@promisechc.org
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33 4th St NW,
Sioux Center, IA
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AN EVENING OF PROMISE
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AN EVENING OF PROMISE
AN EVENING OF PROMISE
FULL NAME
*
EMAIL ADDRESS
*
PHONE NUMBER
*
BUSINESS AFFILIATION
FULL ADDRESS PLEASE INCLUDE STREET, CITY AND ZIP CODE
*
I WOULD LIKE TO
*
Purchase tickets to attend
Become a sponsor
Make a donation
TICKETS
No physical tickets will be mailed. On the evening of the event, your name will be your ticket in!
Individual Tickets
Quantity
Price:
$100.00
Quantity
1 Full Table = 8 tickets
Quantity
Price:
$700.00
Quantity
PLEASE LIST YOUR TABLE GROUP, BUSINESS OR PEOPLE YOU PLAN TO SIT WITH:
(this helps the night of the event to seat people at your table easily)
SPONSOR
*each sponsorship level includes one table
SPONSORSHIP LEVELS
PLATINUM SPONSORSHIP – $10,000+
GOLD SPONSORSHIP – $5,000 TO $9,999
SILVER SPONSORSHIP – $1,000 TO $4,999
SPONSORSHIP AMOUNT
*enter your total sponsorship amount
A TABLE IS INCLUDED IN YOUR SPONSORSHIP!
Yes! We will plan on filling a table of 8 for the event!
Sorry, we are unable to attend this event and just want to sponsor with no table needed.
DONATION
DONATION AMOUNT
*enter your total donation amount
Total
$0.00
I will be paying by
*
Online – click submit and pay through Venmo
Online – click submit and pay through Paypal/Credit/Debit
Check – click submit and mail to Promise, 33 4th St NW, Sioux Center, Iowa 51250 – specify table/donation/sponsor
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