Referral for Dinner with Funders - October 8

(Separate Registration & Fee per attendee)

Identify Key Regional Leaders/agencies who should attend the Invitation OnlyDinner with the Funders.” Limited to 125 attendees representing: Presidents/Board Chairs/EDs of regional agencies: Hospitals, Universities, Museums, EDCs, plus County Judges , Mayors, State Senator/Representative.  Complete the referral information below & return to A Circle of Ten.

 

Same person as above: Check here______  If not, please complete information below.

 

Name____________________________Title_________________________________

 

Agency_______________________________________________________________

 

Address__________________________City____________State_____Zip__________

 

Phone________________Fax__________________Email______________________

 

Send referrals with registration or email to: circleof10@circleof10.org