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MIRA's 17th Annual

Gold Key Gala

Thursday, October 8, 2009

Andiamo's Italia,

Warren

Casino Night

Ticket Price: $ 125

Come join us for a fun evening that includes delicious food, open bar, fabulous dessert bar & gaming to help further our mission of funding research

Chairman: Rob Begosa 

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Gold Key Event Registration Form

 

YES! I want to help MIRA meet the ongoing challenge of funding brain research and attend the 18th annual Gold Key Event on October 8th, 2009

Please press the payment button next to the ticket price and you will be directed to our secure credit card payment server. All transactions are processed through the secure server at PayPal. 

Yes, I want to attend! $125

Please indicate the address where you would like your Gold Key Event information mailed to:

First Name
Last Name
Address
City
State
Zip
Phone:
Email Address:

Thank you so much for your kind support of MIRA. We are grateful for your participation and will email you an acknowledgement. Your tickets and information will be mailed to you shortly.

If there are any questions, please contact us by email at info@miraresearch.org or by phone at 800-896-MIRA.

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Questions regarding this web site can be directed to webmaster@miraresearch.org  
Copyright © 2001 Mental Illness Research Association. All rights reserved.
Revised: August 18, 2009 .
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info@miraresearch.org