uniTy
Coming Together for Transgender Health, Research, and Rights

Sunday, June 4th
6-10 PM

The Edison
108 W 2nd St #101
Los Angeles, CA 90012




Required fields are indicated with an asterisk (*).
Tickets
SelectDescriptionAmount
General Admission - $50 per ticket ($25 tax-deductible)
VIP - $125 per ticket ($100 tax-deductible)
  • 1 GA ticket, plus
  • Sponsor 3 members of the LGBT community to attend
Sub-Total:
Tax-Deductible:
Tax-deductible Gift

If you are unable to attend the event, but would like to make a gift, please designate amount below.

Your contribution to The Williams Institute is greatly appreciated.

I would like to make a fully tax-deductible gift of    Other $  

Grand Total:
Tax-Deductible:
 
GUESTS (Please complete only if purchasing tickets for others.)

If more than five additional guests will be attending, please enter additional names in Comments box.
 * Guest # 1:
 * Guest # 2:
 * Guest # 3:
 * Guest # 4:
 * Guest # 5:

Personal
Title:
 
* First name:  
  Middle name:
* Last name:  
  Suffix:

Contact Information
* Street:  
 
U.S. Addresses  
*   City, State, Zip:
 
 
 
Non-U.S. Addresses  
  Non-U.S. City/County
  or Province/Postal Code:
 
  Country:
 
* This address is my:  
* Home telephone:    
Business telephone:  

* E-mail address:  
* This e-mail is my:  

Matching Gift

  My/my spouse's employer will match my gift.
  Company name for matching gifts:
  This company is:
Payment method:
 
Comments: