2018 naisA Gala Contribution Form 2018 naisA Gala Contribution Form If you are human, leave this field blank. I pledge the following to support naisA Global's 2018 fundraising gala. I will: I pledge the following to support naisA Global's 2018 fundraising gala. I will: * Purchase one table at $5000 for 10 seats: Table Sponsor (5 VIP Reception passes & Logo placement in gala marketing and program) Purchase a half table at $2500 for 5 seats: Strategic Sponsor (3 VIP reception passes & Listing in gala program) Become a contributor by purchasing 2 tickets for $1000 (2 VIP reception passes & Listing in gala program) Make a cash donation to sponsor a protégé as I'm not available for the Gala date Contact Details First Name * Last Name * Company/Organization * * I am making this contribution as a gift on behalf of my company/organization I am making this contribution as a personal gift Email * Phone * Mailing Address Mailing Address Mailing Address Mailing Address City City State/Province State/Province Zip/Postal Zip/Postal Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Côte d'Ivoire Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthelemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Country Pledge Levels Gala Sponsorship Purchase Table Sponsor: $5,000 (5 VIP Reception passes & Logo placement in gala marketing and program) Strategic Sponsor: $2,500 (3 VIP reception passes & Listing in gala program) Contributor: $1,000 (2 VIP reception passes & Listing in gala program) Sponsor a protégé: $350 Purchase Multiple Individual Tickets (Individual ticket: $350) Amount of Tickets Method of Payment Tax ID Number: 46-2591338 (Institute of Asian Scholars, Inc. DBA: naisA Global) Total Amount $ * Payment Method * I will pay by check (Checks should be made payable to “naisA Global" at 750 9th St, NW Suite 650 Washington, DC 20001) I will purchase with a credit card online at the eventbrite after submitting the form Please send invoice for my pledge to the Email address above Submit 2018 naisA Global Brochure View our 2018 Brochure here. Corporate Sponsorship Packet View our Corporate Sponsorship Packet here.