2024 Highland Gala

"*" indicates required fields

Sponsorship Option*

Number of Tickets*

First Name*

Last Name*

Email Address*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Please select your type of donation (for sponsorships and underwriting only)

Company Name (if applicable)

For sponsor recognition purposes, please indicate your preference (for sponsorships and underwriting only)

If you are not submitting a logo, please indicate how your name should be listed for recognition purposes. (i.e. Dr. and Mrs. John Doe, John and Jane Doe, The Doe Family etc.)

If you know your guests names, please enter their names in the space provided along with email addresses

Please indicate if any of your guests have dietary restrictions

Please send guest names and contact information to Brooke Whowell at URMCEvents@urmc.rochester.edu by March 1, 2024.

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