The West Valley Foundation is hosting the César Chávez Breakfast on March 30, 2018 at the Glendale Civic Center.
  Registration - Table - $500
The name and contact information below should be for the person filling out this form.
We may need to contact you to clarify the information for the reservation.

* = required fields
*First Name:
*Last Name:
Mailing Address:
*Phone Number:
*Email Address:

Names of Persons Attending that will be seated at the table:
If you do not have ALL of the names at the time you are filling out this form, then fill in as many names as you can before submitting.

To add or change Attendee names, email Dawna Kremin or call 623-845-3682 and provide the remaining names or changes. It is important this step be completed in order to guarantee participants proper placement and place cards at the table.

Table Participant Names  
Attendee 1
Attendee 2
Attendee 3
Attendee 4
Attendee 5
Attendee 6
Attendee 7
Attendee 8
Attendee 9

After you click the submit button below you will be redirected to our payment page.
Payments will be made using PayPal.

Click the Donate Button for the Sponsorship level you registered for. Have your credit card information ready to fill in on the appropriate PayPal page. After the payment has been finalized, you should get a receipt from the PayPal.

If you have any problems submitting this form, making payment, or do not get a receipt for your payment transaction, contact Dawna Kremin at 623-845-3682.