You may make your reservations online in two ways. Both require that you fill out this form and e-mail us the information by clicking the SUBMIT button. You can choose whether to send us a check payable to BE for Change - JJ Dinner, mailed to

JJ Dinner c/o Nagler
4463 Nueces Drive
Santa Barbara CA 93110

or pay online by credit card or direct bank debit through PayPal.

If you wish to send your payment through PayPal's secure site, just click the PayPal button on our acknowledgment page, which you'll see after you've submitted this form.

Please reserve Amount
tickets at $50 (if payment received by October 1) $
tickets at $65 (if payment received between October 2 and 14) $
tickets at $75 (if payment received after October 14 . . . or at the door if available) $
or  
I would like to help underwrite the dinner as a  
Co-host^ $1,500 / 8 tickets (full table) $
Patron^ $1,000 / 4 tickets $
Sponsor^ $500 / 2 tickets $
Friend^ $150 / 1 ticket $
I cannot attend but would like to make a contribution $

^If we receive your paid reservation by October 1, your name will appear in the evening's program. Underwriters will be invited to a pre-dinner reception with our honored guests.

 

 

I am mailing a check payable to "JJ Dinner - BE for Change"
I am paying through PayPal

* Information below marked with an asterisk is required by state and federal campaign finance laws.

TOTAL

$
*Name
  
*Address
  
*City
  
*State
  
*Zip
  
E-Mail
  
*Phone
  
*Occupation
  
*Employer
  

Special Instructions

There will be assigned seating at tables for eight. Let us know the people with whom you’d like to sit and list them here; we’ll do our best to accommodate you. (Why not get together with your friends and plan your table of eight?! We will honor your arrangements.)

Co-hosts, patrons and sponsors: please list you guests’ names here.

Contributions to BE for Change are not tax deductible for federal or state income tax purposes. Because of the involvement of a federal candidate or officeholder with this event, we are only able to accept contributions of up to $2,100. We do not accept funds from corporations, labor organizations, or other federally prohibited sources.