FOURTH ANNUAL TRANSFORMATIONS Join us on November 5, 2011 for an elegant evening of dining, dancing and celebration at the Ritz-Carlton, San Francisco for the fourth annual Transformations Gala. Your support will help raise funds for life-changing surgeries for children and adults with clefts, disabling burns and hand injuries. Event highlights include: Cocktail reception followed by dinner A premier live auction of unique and luxury items Fund-the-Need to support those with little access to surgical care Award presentations Masters of Ceremonies Adam Curry and Micky Hoogen HONORARY CO-CHAIRS Kholoud and Nevan Elam Dr. Hoyoung Huh and Eleanor Park AWARD RECIPIENTS WILLIAM C. LAZIER LEADERSHIP AWARD Presented to McKinsey & Company and Gary Pinkus Managing Director, Western U.S. McKinsey & Company has been a driving force behind the evolution of ReSurge s international development model. Their pro-bono consultation helped lead to the establishment of 11 surgical outreach centers around the world, empowering local medical teams and providing surgery to the poor on a year-round basis. Currently, McKinsey is helping to identify a rapidly scalable business model for an initiative to address the forgotten global health crisis of burns. Gary Pinkus served on the ReSurge board of directors for nine years. DONALD R. LAUB HUMANITARIAN AWARD Presented to Dr. Hien Thi Nguyen Chief of the Anesthesia Department at Trieu An Hospital, Ho Chi Minh City, Vietnam Dr. Hien Thi Nguyen has worked with ReSurge as a leader and partner for nearly 21 years. In addition to serving as an anesthesiologist and translator, in 2000 Dr. Nguyen became ReSurge s chief contact in Vietnam. Since then, she has organized countless ReSurge team trips to remote provinces across Vietnam, changing lives and restoring hope for thousands of patients. ReSurge s Vietnam program would not be possible without her tireless efforts.
SPONSORSHIP OPPORTUNITIES $25,000 HEALING BODIES SPONSOR One room for two people at the Ritz-Carlton, San Francisco, night of gala Champagne service at dinner table Valet parking for all table guests One full-page ad in the event program Recognition as a Healing Bodies Sponsor at the gala and on the ReSurge website Tax deductible portion is $22,850 $10,000 CHANGING LIVES SPONSOR Champagne service at dinner table Valet parking for all table guests One full-page ad in the event program Recognition as a Changing Lives Sponsor at the gala and on the ReSurge website Tax deductible portion is $8,160 $5,000 EMPOWERING COMMUNITIES SPONSOR One half-page ad in the event program Recognition as an Empowering Communities Sponsor at the gala and on the ReSurge website Tax deductible portion is $3,350 $3,000 TABLE OF FRIENDS Table of ten guests Recognition as a Table of Friends at the gala and on the Resurge website Recognition in gala program Tax deductible portion is $1,350 $1,500 PARTNER IN HEALING SPONSOR Two tickets with premier seating Recognition as a Partner in Healing Sponsor at the gala and on the ReSurge website Recognition in gala program Tax deductible portion is $1,170 $300 FRIEND One ticket to attend the gala event Tax deductible portion is $135
RESERVATION FORM TO BE ACKNOWLEDGED IN THE INVITATION RESPOND BY AUG. 12, 2011 TO BE ACKNOWLEDGED IN THE PROGRAM RESPOND BY OCT. 7, 2011 INDIVIDUAL OR COMPANY INFORMATION (include logo if applicable) Name as it should appear in ReSurge International materials (please indicate if you wish to remain anonymous) Contact Person City State Zip Code Phone Email SPONSORSHIP LEVEL Healing Bodies Sponsor $25,000 Changing Lives Sponsor $10,000 Empowering Communities Sponsor $5,000 Table of Friends $3,000 Partner in Healing Sponsor (two tickets) $1,500 Individual Ticket(s) $300 Qty: As a table sponsor, please use my ad space to feature a patient story. IF YOU ARE UNABLE TO ATTEND, BUT WISH TO SUPPORT SURGERIES FOR THE POOR IN THE DEVELOPING WORLD, PLEASE CHOOSE FROM THE FOLLOWING LEVELS: $50,000 $5,000 $250 $25,000 $2,500 $100 $10,000 $1,000 $50 BILLING INFORMATION I am enclosing a check with this completed form. (Please make checks payable to ReSurge). Please charge my credit card: Visa MasterCard American Express Name on Card Card Number Expiration Date Signature Please send me an invoice. ReSurge International is a 501(c)3 nonprofit organization. Tax ID no. 23-729-7770.
TABLE INFORMATION NAMES OF TABLE GUESTS ARE REQUESTED BEFORE OCT. 21, 2011. Please include your guests names and addresses so that we can welcome them and share event information, auction highlights and directions. I have seat(s) at my table that ReSurge can sell to single/couple ticket purchasers to raise even more money for surgeries.
AUCTION PROCUREMENT FORM MUST BE RECEIVED BY SEPT. 16, 2011 TO BE RECOGNIZED IN PROMOTIONAL MATERIALS DONOR INDIVIDUAL / COMPANY INFORMATION Name as it should appear in ReSurge International materials (please indicate if you wish to remain anonymous) Contact Person City State Zip Code Phone Email DONATION INFORMATION Brief description of donation Value of donation Detailed description for catalog (i.e. color, size, etc.), including restrictions. ITEM DELIVERY INFORMATION Item accompanies auction form (if not, please contact Tracey Thurston, contact information below, to discuss delivery arrangements prior to Oct. 14, 2011). Item is intangible, but an official certificate accompanies auction form. I would like ReSurge to create a certificate for the item using the details I have described above. You will receive a letter from ReSurge acknowledging your donation of the described item. ReSurge International is a 501(c)3 nonprofit organization. Tax ID no. 23-729-7770.