Personal Information

Full Name *

Date of Birth *

Email Address *

Phone Number *

Address *

Current SCI International Membership Number (if applicable)

Membership Type Selection

Please select your preferred membership level:

Regular $120

Bronze $350

1 entry passes for gala dinner

Silver $500

2 entry passes

Gold $1,000

2 entry passes front stage

Pearl Foundation $5,000

Front stage table for 7

Honorable Lifetime Member $1,500

Lifetime membership

Important: This form must be completed and submitted by July 31st. Reservation will be valid once payment has been received.

Name *

Surname *

Address *

ZIP Code *

City *

Country *

Email *

Phone *

Please select which event(s) you would like to attend:

September 12th Only $250 per person

One Event Night

September 13th Only $250 per person

One Event Night

Both Nights $450 per person

Two Event Nights (September 12th & 13th)

Table Reservation $1500 for 7 persons

One Event Night for 7 People

Number of Accompanying Guests