Join the UCLA School of Dentistry to celebrate 50 years of the
Wilson-Jennings-Bloomfield UCLA Venice Dental Center
providing dental care to the community.

Saturday, September 28, 2019
5:00 pm
323 Lincoln Blvd, Venice, CA 90291

The UCLA School of Dentistry presents several opportunities for corporate and donor promotion. In addition to your support of excellence in education, research, patient care, and community service, sponsorships include the following benefits.

For questions, please contact the Office of Development at (310) 206-6063 or email development@dentistry.ucla.edu.



Required fields are indicated with an asterisk (*).
Ticket Registration
SelectDescriptionAmount
Individual Tickets – $100 ($25 Tax-Deductible) per person
Sub-Total:
Tax-Deductible:
Sponsorship
SelectDescriptionAmount
Platinum Sponsor: $50,000 ($48,021 tax deductible)
  • All the benefits of a Gold Sponsor
  • VIP Admission for 25 – Early entry at 4:00p.m.
  • VIP parking for 8 cars
  • Name or company logo on step and repeat
Gold Sponsor: $25,000 ($23,810 tax deductible)
  • All the benefits of a Silver Sponsor
  • VIP Admission for 15 – Early entry at 4:00p.m.
  • VIP parking for 5 cars
  • Sponsorship acknowledgement by the Dean
Silver Sponsor: $10,000 ($9,211 tax deductible)
  • All the benefits of a Bronze Sponsor
  • VIP Admission for 10 – Early entry at 4:00p.m.
  • VIP parking for 3 cars
Bronze Sponsor: $5,000 ($4,550 tax deductible)
  • All the benefits of a Founding Sponsor
  • VIP Admission for 6 – Early entry at 4:00p.m.
  • Name or company logo prominently displayed at event
Founding Sponsor: $1,969 ($1,669 tax deductible) (year the VDC was established)
  • VIP Admission for 4 – Early entry at 4:00p.m.
  • Name or company logo on all printed materials and media outreach
Sub-Total:
Tax-Deductible:
Additional Gift

I am unable to participate in the event, but would like to make a tax-deductible contribution.

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:

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:  

Payment method:
 
Your First Guest:
 First Name:
 Last Name:
 Email address:
 Alumnus/a of UCLA?:
 UCLA graduation year:
Your Second Guest:
 First Name:
 Last Name:
 Email address:
 Alumnus/a of UCLA?:
 UCLA graduation year:
Your Third Guest:
 First Name:
 Last Name:
 Email address:
 Alumnus/a of UCLA?:
 UCLA graduation year:
Your Fourth Guest:
 First Name:
 Last Name:
 Email address:
 Alumnus/a of UCLA?:
 UCLA graduation year:
Your Fifth Guest:
 First Name:
 Last Name:
 Email address:
 Alumnus/a of UCLA?:
 UCLA graduation year:
Your Sixth Guest:
 First Name:
 Last Name:
 Email address:
 Alumnus/a of UCLA?:
 UCLA graduation year:
Your Seventh Guest:
 First Name:
 Last Name:
 Email address:
 Alumnus/a of UCLA?:
 UCLA graduation year:
Your Eighth Guest:
 First Name:
 Last Name:
 Email address:
 Alumnus/a of UCLA?:
 UCLA graduation year:
Your Ninth Guest:
 First Name:
 Last Name:
 Email address:
 Alumnus/a of UCLA?:
 UCLA graduation year:

 
Comments: