BJEOC 60th Anniversary Gala

BJEOC 60th Anniversary Gala
A. Contact Information
Name*

First NameLast Name
Organization
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Affiliation*

BJEOC StaffBJEOC Board of Directors/Policy CouncilCommunity Partner/Guest
How Would You Like to Participate?*

⭕ Gala Admission (Individual or Table)⭕ Souvenir Booklet Advertising Only (Deadline Feb. 28th, 2026)⭕ Both Gala Admission and Souvenir Booklet Advertising
Ad Type*

Full Page Ad - $300Half Page Ad - $200Quarter Page Ad - $100Business Card Ad - $75
Total Amount (Ads)
Ad Artwork Upload (File Upload)

Cancelof
B. Ticket Type*

Individual Ticket ($125 Donation)Table (8 seats) ($1,000 Donation)
C. # of Individual Tickets*
Individual Tickets
Table Number
C. # of Tables*
D. Total Amount
Payment Method (Staff)*

Payroll DeductionPay Now (via Paypal)Cash App
Payment Method (Community Partner/Board/Policy Council)*

Pay Now (via Paypal)Cash App
F. Payroll Deduction Options (Staff)*

1 Deduction2 Deduction3 Deduction
$ Payroll Deduction Total Amount Due
Payroll Authorization*

I authorize payroll deductions for the total amount listed above. (Please check the box, sign and date below for authorization)
Signature*

Clear
Date*

MonthDayYear
Date
Cash App Total Amount Due
Cash App Instructions

Please send your payment manually via Cash App to:
$BeaufortJasperEOC

In the memo, include:

Full Name, “60th Gala”
Your registration will be confirmed once payment is received.
Paypal Total Amount Due
PayPal Payment Instructions

Please click the button below to complete your payment securely through PayPal.

When prompted, enter the amount shown above Paypal Total Amount Due.

In the notes/memo field, please include:
Your Full Name + “BJEOC 60th Anniversary Gala”

Once payment is submitted, return to this form and click Submit Gala Donation.
How Would You Like to Participate?*

⭕ Gala Admission (Individual or Table)⭕ Souvenir Booklet Advertising Only⭕ Both Gala Admission and Souvenir Booklet Advertising
Should be Empty:

BJEOC 60th Anniversary Gala

A. Contact Information