Test Form – OPICA Adult Day Care Program & Counseling Center

SUPPORT FOR OLDER ADULTS WITH MEMORY LOSS AND THEIR FAMILIES

Virtual Forget-Me-Not Luncheon 2021

VIRTUAL SPONSORSHIP OPPORTUNITIES

NOTE: Please send your print-ready PDF or .jpg artwork to craig@opica.org by May 17, 2021. You may also supply text, and we will create the ad.

Sponsorships include full page tribute and recognition at the virtual luncheon.

VIRTUAL TRIBUTE

Number of tickets/lunch delivered - Salmon: $175.00

Quantity - Salmon

Number of tickets/lunch delivered - Vegetarian: $175.00

Quantity - Vegetarian

IN LIEU OF DELIVERING MY LUNCH PLEASE DONATE IT BACK TO OPICA

Number of virtual tickets: $175.00

Quantity - Virtual Tickets

OUT OF TOWN VIRTUAL TICKET

Number of Out-of-town virtual tickets: $150.00

Quantity

I/WE ARE UNABLE TO ATTEND PLEASE ACCEPT MY DONATION TO OPICA

First Name *

Last Name *

Address *

City *

State *

Zip Code *

Email *

Phone *

If lunch to be delivered to another address, please list address here:

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