Albany Institute of History & Art
125 Washington Avenue

Albany, New York

12210

518-463-4478

information@

albanyinstitute.org

 

 

2004 Museum Ball

 

 & Contemporary Art Auction

 

 

March 27, 2004

Response Form

Please complete the following form, print it and send it along with your contribution to:

 

Albany Institute of History & Art

External Relations Division

125 Washington Avenue

Albany, NY 12210

 

For questions, information, to become an AIHA member or to charge your Museum Ball tickets by phone, please contact the External Relations Division at 518-463-4478.

 


 

Name (s) __________________________________________

 

Address___________________________________________

 

City, State, Zip_____________________________________

 

Daytime Phone_____________________________________

 

Please reserve_____Benefactor ticket(s) at $500 each*

Please reserve_____Patron ticket(s) at $250 each*

Please reserve_____AIHA Member ticket(s) at $150 each

Please reserve_____Non-Member ticket(s) at $200 each

Please reserve_____Junior ticket(s) (<35 years) at $125 each

 

(Please note that $75 of each ticket represents the fair market value of goods and services and the remaining portion is tax-deductible.)

 

q Enclosed is a check or money order in the amount of  $_________ made payable to:

 Albany Institute of History & Art

OR

q Please charge the amount of $__________ to:
q Visa q MasterCard
q Discover q American Express
Card Number:____________________________

 

Expiration Date:__________________________

 

Signature:____________________________________________

 

The Marriott is holding a block of rooms for Museum Ball guests at a special reduced rate.  If interested, please call the Marriott at (800) 443-8952 for the $89 AIHA rate for March 27th.


 


 

Seating Preference:

 

_____I/We would like to reserve a table of 10 including the following guests.

 

_____I/We would like to be seated with the following guests.

 

Name ______________________________________________

 

Name ______________________________________________

 

Name ______________________________________________

 

Name ______________________________________________

 

Name ______________________________________________

 

Name ______________________________________________

 

Name _____________________________________________

 

Name _____________________________________________

 

______I/We prefer to be seated away from the band.

 

Dietary Restrictions:_______________________________

 


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2004

Museum Ball & Contemporary Art Auction

  • Response Form

 


 

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