Mayaangelou

Ticket Prices: $150 (includes Gold Circle Seating, VIP Reception 6:30 -7:30 p.m.,
and Program listing) $75 (Silver Circle Seating);
$50 (Bronze Circle Seating); $25 (General Seating)

Name: Title:
Company:
Street:
City: State: Zip:
Telephone: Day Evening:
Email

Request Information and Comments


PAYMENT METHOD:
Credit card is the only payment method you can use to register on line
Please be advised that is not a secured server.
Please mail check or money order to PBWC together with this form.
Registration not complete until payment is received.

Visa MasterCard American Express Money Order Personal Check

Card Number Expiration Date Amount $

Mailing my check number for $ payable to PBWC, Inc.

I am unable to attend but I would like to sponsor
high-school girls for the evening at $50 per person. Total $

Submit complete registration form online
Please be advised that is not a secured server
or print and Fax to 650-548-0840
or print and mail to PBWC, Inc. PO Box 6657, San Mateo, CA 94403

please call: 650-548-2424