Gala Web Registration Form
* Donor Name:
* Email Address:
* Phone:
* Address:
* City, State, Zip:
Additional Comments:
Preferred Reservation
Number of Patron Guests $250/Person:
Number of Dinner Guests $150/Person:
Number of After-Hours Guests $75/Person:
Dr. Tsai Gourmet Meal Raffle Tickets
Take a Chance $500/Raffle Ticket:
Raffle Tickets (1 for $50 or 3 for $100) for 5 Choice Packages Worth $5,000 Each
Raffle Tickets:
* Payment Amount:
Technical Support
If you need technical support for this online payment processing application, please send an email to