Print this page and return the completed form to

Americans for Peace Now
5870 W. Olympic Blvd.
Los Angeles, CA 90036
fax 323-934-3550, or

Contact us at 323-934-3480 or apnwest@peacenow.org

Note - Any donation for tickets and/or tribute ads are fully tax-deductible minus the cost of the meals, if attending.

$200 per ticket / $350 per pair
(see below for ticket/table packaged with tribute journal ads)

Please reserve ________ tickets in the amount of $ ____________

(Discount and/or donated tickets for students, and possibly others, available.  Inquire at apnwest@peacenow.org or 323-934-3480)

____ $100 - Listing (name only)

____ $200 - One-Eighth Page

____ $300 - Quarter Page (includes one luncheon ticket)

____ $500 - Half Page (includes two luncheon tickets)

____ $1,000 - Supporter of Peace Page (+ four tickets)

____ $1,800 - Affirmer of Peace Page (+ six tickets)

____ $3,600 - Guardian of Peace Page (+ table of ten)

____ $5,000 - Seeker of Peace Page (+ table of ten)

____ $10,000 - Pursuer of Peace Page (+ table of ten)

____ $15,000 - Defender of Peace Page (+ table of ten)

(YOU WILL BE CONTACTED IF YOU SELECT A TRIBUTE JOURNAL OPTION ABOVE)

Send a check (payable to 'Americans for Peace Now'), or Credit Card Payment

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