Reserve My Table or Seat -

Fill out this form completely to make a table reservation or purchase individual seats for the Annual Benefit Dinner by Friday, September 20.

Prefix
First*
Last*
Suffix
Phone*
Email*
Address*
City*
State*
Zip*
Are You a Current Leadership Circle Member*
- Yes
- No
Are You a Sustaining Member*
- Yes
- No
What is Your Leadership Circle Membership Level*
What is Your Sustaining Membership Level*
Champion level Sustaining Members can claim two dinner seats and two places at the VIP reception. Advocate level Sustaining Members can claim two dinner seats.
Choose Your Table or Seat*
Your Table or Reservation Name*
Recipient Organization*
- Texas Alliance for Life, Inc.
  (For legislative efforts, not tax-deductible; may be used for supporting or opposing federal candidates.)
- Texas Alliance for Life Trust Fund
  (For education and litigation efforts, tax-deductible.)
- Texas Alliance for Life State Political Action Committee (TAL State PAC)
  (To help elect state and local pro-life candidates, not tax-deductible.)
- Texas Alliance for Life Federal Political Action Committee (TAL Fed PAC)
  (To help elect federal pro-life candidates, not tax-deductible.)
Occupation and Employer*
Total
$0.00
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Seats and Tables are Still Available for Purchase. If you receive an error message after submitting your reservation, please call our office at 512-477-1244 to confirm we received it before resubmitting.
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