MedWish International · 2022 Gala Ticket Registration Form

2022 MedWish Gala Ticket Registration Form

Join us Saturday, August 27th at BLDG 17 for our Annual MedWish Gala!

Help us celebrate MedWish International's impact around the corner and around the world as we highlight the milestones from last year's operations.

MedWish International (MedWish) is a Cleveland-based nonprofit organization that saves lives and the environment by repurposing surplus medical supplies and equipment to provide humanitarian aid around the world. Since our inception in 1993, MedWish has served 114 countries, reduced waste for a healthier planet, engaged thousands of local volunteers, and impacted millions of lives.

Please contact gala@medwish.org or 216.692.1685 x33 with any questions.

Amount *	Quantity
$250 - Single Ticket
$2,500 - Table (includes 10 guests)

Contact Information

Name

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First Name

Last Name

Email

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Verify Email

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Address

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Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Phone

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Guest 2 Name

First Name

Last Name

Table Guest 2 Name

First Name

Last Name

Guest 3 Name

First Name

Last Name

Table Guest 3 Name

First Name

Last Name

Guest 4 Name

First Name

Last Name

Table Guest 4 Name

First Name

Last Name

Guest 5 Name

First Name

Last Name

Table Guest 5 Name

First Name

Last Name

Guest 6 Name

First Name

Last Name

Table Guest 6 Name

First Name

Last Name

Guest 7 Name

First Name

Last Name

Table Guest 7 Name

First Name

Last Name

Guest 8 Name

First Name

Last Name

Table Guest 8 Name

First Name

Last Name

Guest 9 Name

First Name

Last Name

Table Guest 9 Name

First Name

Last Name

Guest 10 Name

First Name

Last Name

Table Guest 10 Name

First Name

Last Name

Please Seat Me With

We cannot guarantee this seating request, but will do our best to accommodate your wishes.

Dietary Restrictions

Please let us know if you or any of your guests have any dietary restrictions. Please provide details and the names above.

In an environmental effort to reduce paper usage, MedWish donors have the option to receive thank you letters/donation receipts via email or hard copy. Please select which manner you would prefer to receive your donation acknowledgement.

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Tax-Deductible Contribution

I/We wish to help MedWish International with our 100% tax-deductible contribution.

Tax-Deductible Contribution Amount

$