Holiday Rose Special Full Page Ad $500 only during 11/28 - 12/3! Ad Upload for White & Red Ball 2025 Rose Special "*" indicates required fields Step 1 of 7 14% Would you like to Purchase an Ad/Program Listing or give a Donation?* Ad/Program Book Listing Donation- I do not want my name in the Program Book/No ad to be printed A Donation selection above does not provide a spot for you to place your well wishes in the program book. It instead is purely a donation in a debutantes name that is counted towards her total amount raised. No Program Book benefits exist. If you prefer to have your well wishes placed in the book or your name displayed, please select the Ad/Program Book Listing option above.Donation Amount* Name* First Last Company / OrganizationAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneEmail* I wish to give credit to Debutante(s)* Not Designated Karolina Bielaczyc Megan Carlson Emilia Faber Olivia Gebarowski Kaia Karkut Pola Kozikowski Olympia Pindiur Harris Jasmine Smith-Vincent Olivia Strozak Daria Szymelfenig How many ads would you like to purchase?*12345 Ad 1Ad Selection*Please select the type of ad you would like to purchase. Please note that prices do not include processing and handling fees, which will be added during check out.Full- Page Standard ($500.00)Full- Page Gold Border ($1,500.00)Full-Page Silver Border ($1,000.00)Half-Page ($500.00)Quarter-Page ($300.00)Business Card (one side printed) ($150.00)Supporter ONE LINE name and a brief message up to 75 characters (accross from the Debutante Picture) ($100.00)Future Debutante/Escort ($50.00)Former Deb/Escort Only - Full-Page Post Debutante/Escort & 1 ticket Combination ($475.00)Former Deb/Escort Only - Full-Page Ad ONLY ($300.00)Former Deb/Escort Only - Half-Page Ad ONLY ($200.00) Ad 1* My ad is complete and ready for the book Create an ad for me Use the same ad as last year I will send my ad at a later time Please send ads by February 2, 2025 to: [email protected](Ad 1) Supporter Line Text exactly as it should appear in the Program Book*This is the line of text will appear across from the Debutante's picture in the Program. Please note you are limited to 75 characters total.(Ad 1) Year of Presentation*(Ad 1) Future Deb/Escort Name*(Ad 1) Former Deb/Escort Meal Selection*Filet MignonFishVegetarian(Ad 1) I wish to be seated next to:Please note that a Former Debutante/Escort Ad must include a picture of the Debutante in her white dress or escort in a tuxedo.To submit a business card, please upload the artwork of the business card side you would like to use. (Ad 1) Please upload your ad*We reserve the right to edit the ad as necessary.Max. file size: 50 MB.(Ad 1) Please enter your ad information in the space below with exact wording and precise details for ad creation*(Ad 1) Page number of previous year's ad*Last year's program book can be found here(Ad 1) Please enter your updated text in the space below with exact wording to be updated on your previous year's ad.*(Ad 1) Files/Pictures for Ad Creation Drop files here or Select files Max. file size: 50 MB, Max. files: 3. Ad 2Ad Selection 2*Please select the type of ad you would like to purchase. Please note that prices do not include processing and handling fees, which will be added during check out.Full- Page Gold Border ($1,500.00)Full-Page Silver Border ($1,000.00)Full- Page Standard ($500.00)Half-Page ($500.00)Quarter-Page ($300.00)Business Card (one side printed) ($150.00)Supporter ONE LINE name and a brief message up to 75 characters (accross from the Debutante Picture) ($100.00)Future Debutante/Escort ($50.00)Former Deb/Escort Only - Full-Page Post Debutante/Escort & 1 ticket Combination ($475.00)Former Deb/Escort Only - Full-Page Ad ONLY ($300.00)Former Deb/Escort Only - Half-Page Ad ONLY ($200.00) Ad 2* My ad is complete and ready for the book Create an ad for me Use the same ad as last year I will send my ad at a later time Please send ads by February 2, 2025 to: [email protected](Ad 2) Supporter Line Text exactly as it should appear in the Program Book*This is the line of text will appear across from the Debutante's picture in the Program. Please note you are limited to 75 characters total.(Ad 2) Year of Presentation*(Ad 2) Future Deb/Escort Name*(Ad 2) Former Deb/Escort Meal Selection*Filet MignonFishVegetarian(Ad 2) I wish to be seated next to:Please note that a Former Debutante/Escort Ad must include a picture of the Debutante in her white dress or escort in a tuxedo.To submit a business card, please upload the artwork of the business card side you would like to use. (Ad 2) Please upload your ad*We reserve the right to edit the ad as necessary.Max. file size: 50 MB.(Ad 2) Please enter your ad information in the space below with exact wording and precise details for ad creation*(Ad 2) Page number of previous year's ad*Last year's program book can be found here(Ad 2) Please enter your updated text in the space below with exact wording to be updated on your previous year's ad.*(Ad 2) Files/Pictures for Ad Creation Drop files here or Select files Max. file size: 50 MB, Max. files: 3. Ad 3Ad Selection 3*Please select the type of ad you would like to purchase. Please note that prices do not include processing and handling fees, which will be added during check out.Full- Page Gold Border ($1,500.00)Full-Page Silver Border ($1,000.00)Full- Page Standard ($500.00)Half-Page ($500.00)Quarter-Page ($300.00)Business Card (one side printed) ($150.00)Supporter ONE LINE name and a brief message up to 75 characters (accross from the Debutante Picture) ($100.00)Future Debutante/Escort ($50.00)Former Deb/Escort Only - Full-Page Post Debutante/Escort & 1 ticket Combination ($475.00)Former Deb/Escort Only - Full-Page Ad ONLY ($300.00)Former Deb/Escort Only - Half-Page Ad ONLY ($200.00) Ad 3* My ad is complete and ready for the book Create an ad for me Use the same ad as last year I will send my ad at a later time Please send ads by February 2, 2025 to: [email protected](Ad 3) Supporter Line Text exactly as it should appear in the Program Book*This is the line of text will appear across from the Debutante's picture in the Program. Please note you are limited to 75 characters total.(Ad 3) Year of Presentation*(Ad 3) Future Deb/Escort Name*(Ad 3) Former Deb/Escort Meal Selection*Filet MignonFishVegetarian(Ad 3) I wish to be seated next to:Please note that a Former Debutante/Escort Ad must include a picture of the Debutante in her white dress or escort in a tuxedo.To submit a business card, please upload the artwork of the business card side you would like to use. (Ad 3) Please upload your ad*We reserve the right to edit the ad as necessary.Max. file size: 50 MB.(Ad 3) Please enter your ad information in the space below with exact wording and precise details for ad creation*(Ad 3) Page number of previous year's ad*Last year's program book can be found here(Ad 3) Please enter your updated text in the space below with exact wording to be updated on your previous year's ad.*(Ad 3) Files/Pictures for Ad Creation Drop files here or Select files Max. file size: 50 MB, Max. files: 3. Ad 4Ad Selection 4*Please select the type of ad you would like to purchase. Please note that prices do not include processing and handling fees, which will be added during check out.Full- Page Gold Border ($1,500.00)Full-Page Silver Border ($1,000.00)Full- Page Standard ($500.00)Half-Page ($500.00)Quarter-Page ($300.00)Business Card (one side printed) ($150.00)Supporter ONE LINE name and a brief message up to 75 characters (accross from the Debutante Picture) ($100.00)Future Debutante/Escort ($50.00)Former Deb/Escort Only - Full-Page Post Debutante/Escort & 1 ticket Combination ($475.00)Former Deb/Escort Only - Full-Page Ad ONLY ($300.00)Former Deb/Escort Only - Half-Page Ad ONLY ($200.00) Ad 4* My ad is complete and ready for the book Create an ad for me Use the same ad as last year I will send my ad at a later time Please send ads by February 2, 2025 to: [email protected](Ad 4) Supporter Line Text exactly as it should appear in the Program Book*This is the line of text will appear across from the Debutante's picture in the Program. Please note you are limited to 75 characters total.(Ad 4) Year of Presentation*(Ad 4) Future Deb/Escort Name*(Ad 4) Former Deb/Escort Meal Selection*Filet MignonFishVegetarian(Ad 4) I wish to be seated next to:Please note that a Former Debutante/Escort Ad must include a picture of the Debutante in her white dress or escort in a tuxedo.To submit a business card, please upload the artwork of the business card side you would like to use. (Ad 4) Please upload your ad*We reserve the right to edit the ad as necessary.Max. file size: 50 MB.(Ad 4) Please enter your ad information in the space below with exact wording and precise details for ad creation*(Ad 4) Page number of previous year's ad*Last year's program book can be found here(Ad 4) Please enter your updated text in the space below with exact wording to be updated on your previous year's ad.*(Ad 4) Files/Pictures for Ad Creation Drop files here or Select files Max. file size: 50 MB, Max. files: 3. Ad 5Ad Selection 5*Please select the type of ad you would like to purchase. Please note that prices do not include processing and handling fees, which will be added during check out.Full- Page Gold Border ($1,500.00)Full-Page Silver Border ($1,000.00)Full- Page Standard ($500.00)Half-Page ($500.00)Quarter-Page ($300.00)Business Card (one side printed) ($150.00)Supporter ONE LINE name and a brief message up to 75 characters (accross from the Debutante Picture) ($100.00)Future Debutante/Escort ($50.00)Former Deb/Escort Only - Full-Page Post Debutante/Escort & 1 ticket Combination ($475.00)Former Deb/Escort Only - Full-Page Ad ONLY ($300.00)Former Deb/Escort Only - Half-Page Ad ONLY ($200.00) Ad 5* My ad is complete and ready for the book Create an ad for me Use the same ad as last year I will send my ad at a later time Please send ads by February 2, 2025 to: [email protected](Ad 5) Supporter Line Text exactly as it should appear in the Program Book*This is the line of text will appear across from the Debutante's picture in the Program. Please note you are limited to 75 characters total.(Ad 5) Year of Presentation*(Ad 5) Future Deb/Escort Name*(Ad 4) Former Deb/Escort Meal Selection*Filet MignonFishVegetarian(Ad 5) I wish to be seated next to:Please note that a Former Debutante/Escort Ad must include a picture of the Debutante in her white dress or escort in a tuxedo.To submit a business card, please upload the artwork of the business card side you would like to use. For two sided options, please upload 2 files. (Ad 5) Please upload your ad*We reserve the right to edit the ad as necessary.Max. file size: 50 MB.(Ad 5) Please enter your ad information in the space below with exact wording and precise details for ad creation*(Ad 5) Page number of previous year's ad*Last year's program book can be found here(Ad 5) Please enter your updated text in the space below with exact wording to be updated on your previous year's ad.*(Ad 5) Files/Pictures for Ad Creation Drop files here or Select files Max. file size: 50 MB, Max. files: 3. Payment InformationPayments can only be collected via credit card during our rose special.* Credit Card Total Credit Card* Please send ads by February 2, 2025 to: [email protected] Please include your order confirmation in your email and write the order number in the subject line. Use code "ROSE" for 10% off your tickets only between 11/28 - 12/3! White & Red Ball Tickets 2025 "*" indicates required fields How many tickets would you like to purchase?*12345678910Ticket prices are as follows: Regular Ticket: $250 Teen Ticket (ages 13-20): $200 Child Ticket (ages 12 and under): $100 Please select your meal choice. Guest Meal Selection*Filet MignonSalmonVegetarianFilet Mignon (ages 13-20 only)Fish (ages 13-20 only)Vegetarian (ages 13-20 only)Child Entrée (12 and under)Mazur DancerCourtesy*Mr.Mrs.Ms.MissDr.Hon.Guest 1 Full Name*Guest 2 Meal Selection*Filet MignonSalmonVegetarianFilet Mignon (ages 13-20 only)Fish (ages 13-20 only)Vegetarian (ages 13-20 only)Child Entrée (12 and under)Courtesy 2*Mr.Mrs.Ms.MissDr.Hon.Guest 2 Full Name*Guest 3 Meal Selection*Filet MignonSalmonVegetarianFilet Mignon (ages 13-20 only)Fish (ages 13-20 only)Vegetarian (ages 13-20 only)Child Entrée (12 and under)Courtesy 3*Mr.Mrs.Ms.MissDr.Hon.Guest 3 Full Name*Guest 4 Meal Selection*Filet MignonSalmonVegetarianFilet Mignon (ages 13-20 only)Fish (ages 13-20 only)Vegetarian (ages 13-20 only)Child Entrée (12 and under)Courtesy 4*Mr.Mrs.Ms.MissDr.Hon.Guest 4 Full Name*Guest 5 Meal Selection*Filet MignonSalmonVegetarianFilet Mignon (ages 13-20 only)Fish (ages 13-20 only)Vegetarian (ages 13-20 only)Child Entrée (12 and under)Courtesy 5*Mr.Mrs.Ms.MissDr.Hon.Guest 5 Full Name*Guest 6 Meal Selection*Filet MignonSalmonVegetarianFilet Mignon (ages 13-20 only)Fish (ages 13-20 only)Vegetarian (ages 13-20 only)Child Entrée (12 and under)Courtesy 6*Mr.Mrs.Ms.MissDr.Hon.Guest 6 Full Name*Guest 7 Meal Selection*Filet MignonSalmonVegetarianFilet Mignon (ages 13-20 only)Fish (ages 13-20 only)Vegetarian (ages 13-20 only)Child Entrée (12 and under)Courtesy 7*Mr.Mrs.Ms.MissDr.Hon.Guest 7 Full Name*Guest 8 Meal Selection*Filet MignonSalmonVegetarianFilet Mignon (ages 13-20 only)Fish (ages 13-20 only)Vegetarian (ages 13-20 only)Child Entrée (12 and under)Courtesy 8*Mr.Mrs.Ms.MissDr.Hon.Guest 8 Full Name*Guest 9 Meal Selection*Filet MignonSalmonVegetarianFilet Mignon (ages 13-20 only)Fish (ages 13-20 only)Vegetarian (ages 13-20 only)Child Entrée (12 and under)Courtesy 9*Mr.Mrs.Ms.MissDr.Hon.Guest 9 Full Name*Guest 10 Meal Selection*Filet MignonSalmonVegetarianFilet Mignon (ages 13-20 only)Fish (ages 13-20 only)Vegetarian (ages 13-20 only)Child Entrée (12 and under)Courtesy 10*Mr.Mrs.Ms.MissDr.Hon.Guest 10 Full Name*I wish to be seated with/near:Billing InformationName* First Last Company / OrganizationAddress* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code PhoneEmail* I wish to give credit to Debutante(s)* Not Designated Karolina Bielaczyc Megan Carlson Emilia Faber Olivia Gebarowski Kaia Karkut Pola Kozikowski Olympia Pindiur Harris Jasmine Smith-Vincent Olivia Strozak Daria Szymelfenig Please enter code: rose The Holiday Rose Special is only valid from 11/28-12/3 to save 10% off your ticket price.This field is hidden when viewing the formWe are only accepting credit card payment during our Rose Special. Credit Card Total Credit Card*Card Details Cardholder Name Please make checks payable to: Legion of Young Polish Women Mail to: Legion of Young Polish Women c/o Cherie Farrell 720 N Larrabee Street #903 Chicago, IL 60654 How did you hear about us?* Debutante Current member Former Guest Dziennik Zwiazkowy Polvision Other
