Donations: $75 per person Table of Ten $750 Cash Bar

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For credit card payment please fill out the form below & fax to 847-803-2383 or call 847-803-2382 & we will fill out the form with the credit card for you. (For your protection, please don’t email this form with a credit card number on it)

Or mail this form with a check or credit card info to: Chicago Tennis Patrons, 2200 E. Devon, Ste 319, DesPlaines, IL 60018 Thank you for your support in helping make the Annual Evening of Champions a great success !

Enclosed is $___________for _________reservations: $75 per person Donations: $75 per person Table of Ten $750 Cash Bar

$5000 Platinum_______ $3000 Gold_______ $1000 Silver_______ $500 Bronze_______ I cannot attend, please accept my donation of $_________ Please Print

Name______________________________________________________________ Address____________________________________________________________ City/State____________________________________________ Zip____________ Phone/Cell ____________________E-Mail_________________________________ Signature___________________________________________________________

Chicken, Qty.________ Vegetarian, Qty.________ Beef, Qty.________ Seating is limited-Reservations accepted by Friday, February 13, 2015. Please make checks payable to Chicago Tennis Patrons, Inc.

Seating is Limited-Reservations accepted by Friday, February 13, 2015 1.

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10. _______________________________________________/Entrée________ Club Affiliation ___________________________________________________ I would like to sit with_______________________________________________ If no entrée is selected, the entrée will be chicken.