EFTA02702727.pdf

PLEASE JOIN BENEFIT CO-CHAIRS GABRIELLE AND LOUIS BACON ALEXANDRA AND STEVEN COHEN EVA AND GLENN DUBIN AMY AND JOHN GRIFFIN WENDY HAKIM JAFFE SONIA AND PAUL TUDOR JONES I I ALLISON AND HOWARD LUTNICK VERONIQUE AND BOB PITTMAN BETH AND DAVID SHAW KATHLEEN AND KENNETH TROPIN NINA AND GARY WEXLER JILL AND PAUL YABLON FOR THE DUBIN BREAST CENTER SECOND ANNUAL BENEFIT MONDAY, DECEMBER 1O, 2O12 HONORING ELISA PORT, MD, FACS AND THE RUTTENBERG FAMILY HOST CYNTHIA MCFADDEN SPECIAL MUSICAL PERFORMANCES CAROLINE JONES, K'NAAN, HALEY REINHART, THALIA, EMILY WARREN MANDARIN ORIENTAL 7:OOPM COCKTAILS LOBBY LOUNGE 8:OOPM DINNER AND ENTERTAINMENT MANDARIN BALLROOM FESTIVE ATTIRE DUBIN BREAST CENTER BENEFIT COMMITTEE PAULINE DANA AND RAFFI ARSLANIAN CHRISTINE MACK MICHELE AND TIMOTHY BARAKETT ALICE AND LORNE MICHAELS LISA AND JEFF BLAU THALIA AND TOMMY MOTTOLA ANN COLLEY DORE HAMMOND AND JAMES NORMILE JULIE ANNE QUAY AND MATTHEW EDMONDS ANN O'MALLEY LISE AND MICHAEL EVANS TRISH PALIOTTA EILEEN PRICE FARBMAN AND STEVEN FARBMAN BETH AND JASON ROSENTHAL TANIA AND BRIAN HIGGINS CAROLYN AND CURTIS SCHENKER LAURA KRUPINSKI LESLEY AND DAVID SCHULHOF MARCY AND MICHAEL LEHRMAN LYNN AND STEPHAN SOLOMON Mount Sinai Dubin Breast Center O11X/ TISCH CANCER INSTITUTE FOR FURTHER INFORMATION, CALL 212-245-6570 DUBINBREASTCENTER a EVENTASSOCIATESINC.COM WWW.DUBINBREASTCENTER.ORG EFTA_R1_02076399 EFTA02702727  DUBIN BREAST CENTER SECOND ANNUAL BENEFIT MONDAY, DECEMBER 1O, 2O12 HONORING ELISA PORT, MD, FACS AND THE RUTTENBERG FAMILY MANDARIN ORIENTAL, NEW YORK CITY PLEASE ADD MY NAME TO THE BENEFIT COMMITTEE AND RESERVE THE FOLLOWING: ❑ ONE PLACE TABLE AT $100,000 Table for 10 at dinner with priority seating, special recognition dunng the evening, One Place listing in the printed program, listing on Dubin Breast Center Annual and Permanent Donor Walls and Diamond Circle benefits of the Dubin Breast Center Circle of Friends. ❑ ONE MISSION TABLE AT $50,000 Table for 10 at dinner with premium seating, special recognition during the evening, One Mission listing in the printed program, listing on Dubin Breast Center Annual Donor Wall and Platinum Circle benefits of the Dubin Breast Center Circle of Friends. ❑ ONE TEAM TABLE AT $25,000 Table for 10 at dinner with excellent seating, One Team listing in the printed program, listing on Dubin Breast Center Annual Donor Wall and Gold Circle benefits of the Dubin Breast Center Circle of Friends. ❑ ONE PURPOSE TABLE AT $10,000 (limited availability) Table for 10 at dinner, One Purpose listing in the printed program, listing on Dubin Breast Center Annual Donor Wall and Silver Circle benefits of the Dubin Breast Center Circle of Friends. ❑ ONE ROOF INDIVIDUAL TICKET(S) AT $2,500 Priority seating for dinner and One Roof listing in the printed program. ❑ ONE INDIVIDUAL TICKET(S) AT $1,000 Seating for dinner and One listing in the printed program. ❑ I am unable to attend but wish to make a fully tax deductible contribution of $ ❑ This gift is in honor of (Please list name and/or company above as you wish it to appear in the printed program) NAME COMPANY ADDRESS CITY STATE ZIP E-MAIL PHONE FAX PLEASE CHARGE MY ❑ Visa ❑ MasterCard ❑ American Express CARD NUMBER EXP. DATE CARDHOLDER SIGNATURE TOTAL $ Please make checks payable to Dubin Breast Center: (Tax-ID# 13.6171197) and return to Event Associates, Inc., 162 West 56th Street, Suite 405, New York, NY 10019. Your contribution less $275 per ticket is tax-deductible. For further information, please contact Debbie Fife: Phone: 212-245-6570 ext. 20, Fax: 212-581-8717, E-mail: [email protected] Please visit our website at www.dubinbreastcenter.org to learn more about the Dubin Breast Center Circle of Friends benefits. El ei Dubin Breast Center 0. MS /Sell CANON IIIISIIIIIII EFTA_R1_02076400 EFTA02702728