2025 Annual Dinner Reservation: Annual Dinner Sponsor Annual Dinner SponsorshipSponsor Level(Required) Table Sponsor (4 seats): $1,200.00 Silver Sponsor (6 seats): $2,500.00 Gold Sponsor (8 seats): $5,000.00 Platinum Sponsor (10 seats): $10,000.00 Organization(Required)Reservation Name(Required) First Last Email(Required) Mobile Phone Number(Required)By providing your mobile number and submitting this form, you agree to receive calls and/or text messages from CASE related to the 2025 Annual Dinner. Message and data rates may apply. You can opt-out at any time by replying STOP. View our Privacy Policy here: https://ctcase.org/privacy-policy/.Vegetarian entrée(Required)We will be serving a chicken entrée for the main course. A vegetarian entrée will be available. Please indicate if you require a vegetarian entrée. Yes No For each guest, please provide the guest name and whether a vegetarian entrée is required.Guest First NameGuest Last NameVegetarian Entrée (Y/N) Add RemoveTotal Method of Payment(Required)Please indicate whether you will be paying via credit card, or if you would prefer that CASE send an invoice. We would like to pay via credit card Please send us an invoice InvoicePlease provide the contact information to which the invoice should be sent. Name First Last Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email PhonePhoneThis field is for validation purposes and should be left unchanged.
