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Friends of Bruin Rugby

Presents

2022 UCLA Rugby Hall of Fame

Banquet

Saturday, April 9, 2022
5 pm-6 pm Cocktail Reception and Program from 6 pm-9 pm
Ackerman Grand Ballroom


Deadline - March 25

Our 2022 Hall of Fame Class


Lee Carlson ‘54

Dennis Jablonski ‘76

Russ Ortiz ‘88

Chip Howard ‘93

Allen Chen ‘08

James Shandorf ‘10

Recognizing the 50th anniversary of the 1972 UCLA Rugby Team

To pay by check made payable to The UCLA Foundation please print this form and mail to:

The UCLA Foundation
PO Box 7145
Pasadena, CA 91109-9903

*So that your contribution is allocated to the appropriate fund, please include ‘Friends of Men's Rugby 61033C’ on check memo line.

Thank you for supporting UCLA Rugby!

Should you have any questions about the event please contact Willie West at wwest@support.ucla.edu.



Required fields are indicated with an asterisk (*).
Tickets and Tables
SelectDescriptionAmount
Table(s) of 10 - $1,350 each ($1,050 tax-deductible)
Individual ticket(s) - $150 each ($120 tax-deductible)
Young Alumni ticket (5 years or less since graduation) - $75 each ($45 tax-deductible)
Sponsor a Current Player or a recent Graduate $75 each ($75 Tax Deductible Gift)
Purchase a 1972 Jersey - $150 ($80 tax-deductible)
Hall of Fame Inductees and +1 - Free
Sub-Total:
Tax-Deductible:
Additional Donation

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

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

Grand Total:
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Attendee Names
 * Guest 1 Name:
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Personal
Title:
* First name:
  Middle name:
* Last name:
  Suffix:
   I am making this gift as a proxy for my organization/company, which should be recognized as the legal donor

Joint Gift
* This is a joint gift with
my spouse/partner
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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:
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Matching Gift

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