Ottawa
Gold Medal Plates: A Celebration of Canadian Excellence
Tuesday, November 16, 2010 6:00 pm at National Arts Centre
Net proceeds from Gold Medal Plates are given to the Canadian Olympic Foundation,
which supports athletes and high performance programs such as Own the Podium.
To date, over $4.1 million has been raised.
ATTENDEE INFORMATION
Required Fields
(
)
First Name:
Last Name:
Corporate Table Host First Name:
(
if different from Attendee Name
)
Corporate Table Host Last Name:
(
if different from Attendee Name
)
Corporate Table Name:
(
if Applicable
)
Telephone:
(###) - ###-####
Fax:
(###) - ###-####
Address:
City:
Province:
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
Country:
Country is required.
Postal Code:
E-mail Address:
confirmations will be sent to this email address.
ITEM SELECTION
Please note that all prices in this section DO NOT include tax. Tax will be calculated after you choose your purchases.
Description
Price
Quantity
Individual Ticket
300.00 + TAX
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Corporate Table
3000.00 + TAX
0
1
2
3
4
5
6
7
8
9
10
11
12
Olympian/Paralympian Table
5000.00 + TAX
0
1
2
3
4
5
6
7
8
9
10
11
Platinum Package
10000.00 + TAX
SOLD OUT
Please check here if you would like to receive a charitable tax receipt for any personally purchased ticket or table. Business tax receipts will be issued automatically.
DONATIONS
I would like to donate the following amount to Gold Medal Plates 2010:
$ 500.00
$ 1,000.00
$ 2,000.00
$ 3,000.00
$ 4,000.00
$ 5,000.00
Other
Other Amount:
Please check here if you would like to receive a tax receipt for your donation.