Women's Medical Fund

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Thank you for your support!

Ticket Information

Qty

Description

Amount

Total

VIP Ticket(s) (over 35) Sold Out: Email Judy Walker for waiting list

$225.00

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(includes pre-party and admission to One Night Only)

VIP Ticket(s) (35 and under) Sold Out: Email Judy Walker for waiting list

$100.00

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(includes pre-party and admission to One Night Only)

Over 35 (1 ticket)

$85.00

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35 or younger (1 ticket)

$45.00

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Sponsor front-line abortion provider staff by donating a ticket!

$45.00

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BRING A FRIEND:

1 over 35/1 35-and-under combo (2 tickets)

$120.00

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2 35-and-under combo (2 tickets)

$80.00

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2 over 35 combo (2 tickets)

$160.00

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RAFFLE TICKETS:

$2,500 Luxe Home Merchandise Credit

$20.00

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Grand Prize Chance(s)

Week at Lake house in Maine

$20.00

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Grand Prize Chance(s)

4 courtside seats to an upcoming 76ers game

$20.00

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Grand Prize Chance(s)

Can’t attend but want to make a contribution?
Can you support the event over your ticket price?

$5.00 Contribution

$5.00

$25.00 Contribution

$25.00

$50.00 Contribution

$50.00

$100.00 Contribution

$100.00

$500.00 Contribution

$500.00

Other Contribution

None Of The Above

None

Total: $0.00

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone:

E-mail: *

A receipt will be e-mailed to this address.

I would like to remain anonymous. Please carefully consider an anonymous designation. Listing the names of supporters in our annual newsletter helps fight the stigmatization of abortion.

Tell us who is coming for the check-in list at the door. Filling out the form helps us use our time productively!

Attendee 1:

Attendee 2:

Attendee 3:

Attendee 4:

WMF is a unit of Resources for Human Development, a registered charitable organization.
Registration and financial information is available by calling toll free within PA 1-800-732-0999.
Registration does not imply endorsement.

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *