THE CHICAGO COMMITTEE
TO DEFEND THE BILL OF RIGHTS (CCDBR)
1325 S Wabash Avenue, Suite 105       Chicago Illinois 60605
312-939-0675     fax 312-939-7867     ccdbr@pobox.com     www.ccdbr.org

CCDBR Celebration of the Rosen Family
Event Details

Parking:
Parking is available in the Unite Union Hall parking lots.
On-street parking is also available on VanBuren Street.

Reservations:
Before October 21 -- please print and fill out this form, and send it with your payment to the CCDBR office:
    1325 S. Wabash, Suite 105, Chicago IL 60605-2506
After October 20 -- please email this information to ccdbr@pobox.com right away,
    and bring your payment to the event
(apologies, but we are unable to process credit/debit card payments at this time)

For the Program honoring the Rosens and hearing from Greg Palast

__I want ______ tickets to attend the Program at $30 per person

__I am a student (with current ID) and want to attend the Program at $15

Some scholarships will be available for those who cannot afford the regular price -- leave a message at 312-939-0675

For the Private Reception with the Rosens and from Greg Palast

__ I want ______ tickets to attend the Reception and Program at $100 per person

__I want ______ pairs of tickets to attend the Reception and Program at $150 per couple


__ I cannot attend the Program or Reception, but am making a contribution for scholarships and the general work of CCDBR.


Name:____________________________________________________________

Address:__________________________________________________________

Phone #s:__________________________________________________________

Email address:_____________________________________________________


__I enclose my payment of $_________
      write your check to "CCDBR", or
      to make your contribution tax-exempt & direct it to our educational programs, write your check to the "Bill Of Rights Foundation."