Required fields are indicated with an asterisk (*).
 
Unique Invitation Code
 Please provide the unique 9 digit invitation code provided in the email you received:
Sponsorship Opportunities
As a sponsor of the UCLA Engineering Awards, you have the opportunity to present your brand and message to thousands of UCLA Engineering alumni, supporters, students and faculty, as well as others in the engineering community.
QuantityDescriptionAmount
      Platinum Sponsorship - $25,000 ($15,000 tax-deductible)
  For a full listing of Platinum Sponsorship benefits, please click here.
      Gold Sponsorship - $15,000 ($7,500 tax-deductible)
For a full listing of Gold Sponsorship benefits, please click here.
      Silver Sponsorship - $10,000 ($5,000 tax-deductible)
For a full listing of Silver Sponsorship benefits, please click here.
      Blue Sponsorship - $5,000 ($2,500 tax-deductible)
For a full listing of Blue Sponsorship benefits, please click here.
Sub-Total:
Tax-Deductible:
Tickets
QuantityDescriptionAmount
      Individual Dinner Reservation - $250 ($0 tax-deductible)
      Host a student and/or faculty member - $250 ($250 tax-deductible)
Sub-Total:
Tax-Deductible:
Tax-deductible Gift

I am unable to attend and/or I would like to support UCLA Engineering with a 100% tax-deductible gift.

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

Grand Total:
Tax-Deductible:
 

Personal
Title:
 
* First name:  
  Middle name:
* Last name:  
  Suffix:
UCLA graduation year(s):  

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:
 
Attendee Information
Please indicate name, as you would prefer to see it on a name tag, and the main course choice for all guests, including yourself.

Table sponsors, indicate guest information with known attendees at time of payment. To submit additional guest names, please contact Sarah Low at slow@support.ucla.edu or 310.825.1628
Guest 1
 Name:
 Company Name:
 Professional Title:
 Department:
 Affiliation:
 Secondary Affiliation:
 Meal Selection:
Guest 2
 Name:
 Company Name:
 Professional Title:
 Department:
 Affiliation:
 Secondary Affiliation:
 Meal Selection:
Please note any guests' food allergies.
 Allergies:

To submit additional guest names for Platinum, Gold, Silver or Blue Sponsors, please contact Sarah Low at slow@support.ucla.edu or 310.825.1628

 
Comments: