The Roast of Major Wayne AdkinsAPRIL 1, 20236:00 PM – Reception, 7:00 PM – Dinner & Program On the grounds of the historic Sample‐McDougald House,” 450 NE 10th Street, Pompano Beach, FL 33060 ~ Dressy Casual Attire ~$7,000 Platinum Table Host Top priority table placement Recognition in program and at the event Full-page advertisement in program 3 Bottles of Wine for Table 10 Tickets to event$5,000 Gold Table Host– Recognition in program and at the event Full-page advertisement in program 2 Bottles of Wine for Table 10 Tickets to event$2,500 Silver Table Host– Recognition in program and at the event Half-page advertisement in program– 10 Tickets to event$1,500 Copper Table Host– Recognition in program and at the event Business Card advertisement in program– 10 Tickets to eventI'D LIKE TO BE A TABLE HOST $7,000 / Platinum Table Host $5000/ Gold Table Host $2,500 Silver Table Host $1,500 / Copper Table Host NoneIndividual Tickets0123456789Individual Tickets (Law Enforcement Discount)0123456789Total I'D LIKE TO BE AN UNDERWRITING SPONSORIndividuals and organizations can support the Sample-McDougald House’s Roast of Major Wayne Adkins by underwriting the cost of the event. All funds raised at the Roast support the mission of the historic Sample-McDougald House. Underwriting sponsors will be posted in our program and on banners at the event. $10,000 / Title Sponsor (Includes Platinum Table, $7,000 value) $7,000 / Dinner Sponsor (Includes Gold Table, $5,000 value) $5,000 / Reception Sponsor (Includes Silver Table, $2,500 value) $3,000 / Bar Sponsor (Includes Cooper Table, $1,500 value) $2,000 / Entertainment Sponsor (Includes Event 6 Tickets, $900 value) $750 / Marketing Materials (Includes Event 2 Tickets, $300 value) NoneTotal I’d like to be a PROGRAM ADVERTISERPlease submit camera-ready copy by 5:00 pm, March 20. 2023 by email (.jpg or pdf format) to Lee@Samplemcdougald.org $500 / Back Cover (7 ½” x 4 ¾”) $400 / Inside Back Cover (7 ½” x 4 ¾”) $250 / Full Page (7 ½” x 4 ¾”) $150 / Half Page (3 ¾” x 4 ¾”) $100 / Business Card (1 7/8” x 4 ¾”) NoneTotal YOUR INFORMATIONName First Last PhoneEmail Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Contact PersonDESIGNATED CONTACT PERSON FOR ATTENDEE INFORMATION:Name First Last PhoneEmail CONTACT PERSONDESIGNATED CONTACT PERSON FOR ARTWORK:Name First Last PhoneEmail Upload ArtworkAccepted file types: jpg, gif, png, pdf, Max. file size: 8 MB.Total
