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menu_logo_bottom.jpg (3826 bytes) R.S.V.P.

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Choice Dinner Speaker    Choice Dinner Menu    Choice Dinner Media Release

Fill out the form below to submit your R.S.V.P. for this year's Choice Dinner. Invitations will be mailed in early January, and you can send in your paper invitation instead. If you are not on our mailing list, you can call or email the clinic to request an invitation and be added to our mailing list. If you are also submitting a reservation for a friend, please put their name in the comments box so we know who will be attending.

We are requesting a $50 donation for each dinner ticket. There is a reduced rate of $25 for students or individuals with lower incomes.  Please RSVP by January 22, as this helps us budget appropriately with the event venue.  Dinner ticket prices change to $60 and $30 for tickets after the RSVP date.

You can also donate at higher levels:

Emma-licious  $150  Two dinner reservations and Emma-licious program listing

Emma-sary    $300  Four dinner reservations and Emma-sary program listing

Emma-nence  $500  Table for eight and Emma-nence program listing

If you have any questions about the Choice Dinner, or making your reservations, please call the clinic at 319-337-2112.

To donate by fax or mail, please print the Donation Form (PDF format), include info about # and names of attendees, and submit it to:

The Emma Goldman Clinic
ATTN: Contributions
227 N. Dubuque St.
Iowa City, IA 52242
Fax: (319) 337-2754

To donate online, there are two steps.
1. Please RSVP your information below
2. Please enter your donation with credit card through our secure here


First Name:

Last Name:

Address 1:

Address 2:

City:

State:

Zip Code:

Email:

Telephone:
Country:
Would you like to join our email list? occasional emails inform about actions
                                           and events related to EGC
Would you like to join our mailing list? mailing list includes quarterly newsletters
Level of Donation 

 ie (individual, Emma-sary, etc)
Number of Tickets
Donation Amount: $
Would you like a letter
tax-deduction purposes?

Comments:

If purchasing tickets for more than 1 person, please include names of other attendees. 

   

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