2018 Board Commitment Form

Name*
Prefix First Last
Significant Other's Name
Prefix First Last
Home Address*
Street Address Address Line 2 City State ZIP Code
Work Address
Street Address Address Line 2 City State ZIP Code
Home Phone
Work Phone
Cell Phone*
Email address*
Birthday (mm/dd)*
Employer
Position
Twitter Handle
Other nonprofit/organizational involvement
Examples: nonprofits, houses of worship, clubs, boards
Payment Information*
Pledges must be paid in full by December 31, 2018, unless other arrangements are made by speaking to a staff member.
Credit Card Number
Expiration Date
CVV Number
Karen H. Susman Jurisprudence Award Luncheon
February 22, 2018
- Benefactor - $25,000
- Patron - $15,000
- Defender - $10,000
- Supporter - $5,000
- Individual Tickets - $500
- Young Lawyer Ticket (practicing four years or fewer) - $350
Quantity
Please enter a number from 1 to 99.
Houston in Concert Against Hate
April 4, 2018
- Presenter - $100,000
- Benefactor - $50,000
- Patron - $25,000
- Defender - $18,000
- Guardian - $10,000
- Supporter - $5,000
- Reception + Concert Ticket - $1,250
- Concert Ticket - $500
Quantity
Please enter a number from 1 to 99.
No Place for Hate Luncheon
- Benefactor - $25,000
- Patron - $15,000
- Defender - $10,000
- Sponsor - $5,000
- Ticket - $200
Date TBA
Quantity
Please enter a number from 1 to 99.
Women's Initiative
- Sponsor - $10,000
- Sponsor - $5,000
- Sponsor - $2,500
Event dates + official sponsorship level titles TBA--all include a table
Quantity
Please enter a number from 1 to 99.
General Fund

Balance of pledge not directed to one of the listed programs above will be designated to the General Fund.
Total Gift Amount
$0.00
Please click the following boxes to acknowledge agreement:*
- I hereby give permission for the information contained herein to be included in the ADL Southwest Regional Board Directory
- I hereby consent not to distribute the Board Directory to any third party and to only use it for internal ADL purpose
- I confirm my 2018 ADL Board Member commitment or my intent to recommend a distribution from a philanthropic fund.
Photo Upload
Accepted file types: jpg, png, jpeg, Max. file size: 5 MB.
Please include a photo of yourself for the Board Directory.
Anything else you'd like us to know?

Southwest

2018 Board Commitment