Ottawa
Gold Medal Plates: A Celebration of Canadian Excellence
Wednesday, October 15, 2008 6:00 pm at Hilton Lac Leamy
Proceeds from Gold Medal Plates will be contributed to the Canadian Olympic Foundation to benefit Own the Podium 2010 and Road to Excellence, two sport initiatives aimed at helping Canada’s winter and summer athletes reach the podium at upcoming Olympic and Paralympic Games.
in co-operation with / en collaboration avec
TM
© Copyright 2005, Vancouver Organizing Committee for the 2010 Olympic and Paralympic Winter Games. All Rights Reserved.
MC
Marque de commerce © 2005, Comité d'organisation des Jeux olympiques et paralympiques d'hiver de 2010 à Vancouver. Tous droits réservés.
ATTENDEE INFORMATION
Required Fields
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)
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
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Corporate Table
$ 2,500.00 + TAX
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Olympian/Paralympian Table
$ 5,000.00 + TAX
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Platinum Package
$ 10,000.00 + TAX
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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 2008:
$ 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.