2026 Banquet Registration Form

THE PHILADELPHIA BAPTIST ASSOCIATION
MISSION BANQUET REGISTRATION FORM

Saturday November 14, 2026, 11:00 AM
The Drexelbrook
Drexelbrook Drive & Valley Road, Drexel Hill, PA 19026

Registration Deadline: October 12, 2026
(Registrations not accepted after October 16th)
Please be sure to indicate the number of entrées desired. Luncheon ticket(s) will be forwarded upon receipt of registration and payment to the person listed below. Please list the individual names and meal choices on the attached sheet. Please arrange by table seating. Tickets will be sent to you based on table breakdowns. Actual table numbers will be assigned when the tickets are mailed.
Name:
(Contact person for reservation)
Church or agency name:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone number:
Format: (000) 000-0000.
Email:
example@example.com

Church:
Please print individual names and check off each meal choice below. (Duplicate as needed)

ENTRÉE CHOICES:
Duet Platter: Entrée of Pan Seared Boneless Breast of Chicken and Atlantic Salmon Filet
Vegan Platter: Roasted Mediterranean Vegetable Napoleon
Children's Meal: Chicken Tenders with French Fries
Number of Duet
Number of Vegan
Number of Children's meals
Enclosed is payment for:
Number of individual ticket(s) @ $65.00
$ Amount for Individual Ticket(s)
Number of Children's Tickets @ $35.00 (Age 12 & under)
$ Amount for Children's Ticket(s)
Silver @ $ 1,000
One table of 10, one full page ad, listing in souvenir journal
and on-screen during event
Gold @ $1,800
Two tables of 10, two full page ads, listing in souvenir journal
and on-screen during event
Platinum @ $3,400
Four tables of 10, two full page ads, listing in souvenir journal
and on-screen during event
Diamond @ $5,000
Six tables of 10, four full page ads, listing in souvenir journal
and on-screen during event
TOTAL AMOUNT ENCLOSED
You may pay online through the PBA website (philadelphiabaptist.org) or by sending a check to the PBA.

Make checks payable to "Philadelphia Baptist Association"

Mail payment and registration to:
Philadelphia Baptist Association, ATTN: Mission Banquet, 8711 Ridge Avenue, Philadelphia, PA 19128-2023

Fax: 215-482-8232

Adult Ticket

$65.00 Quantity

Child Ticket

$35.00 Quantity

Silver

$1,000.00 Quantity

Gold

$1,800.00 Quantity

Platinum

$3,400.00 Quantity

Diamond

$5,000.00 Quantity

Total

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

If you require additional information contact Janet Reedy at the PBA office (215-482-8222, ext. 12) or jhreedy@philadelphiabaptist.org.
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THE PHILADELPHIA BAPTIST ASSOCIATION