Registration

Fields marked * require an entry.

Package Name	Amount	Subtotal

Heart & Stroke Ball Tickets - Individual (online)	$150.00	$0.00

Includes: Reserved Seating for 1

Heart & Stroke Ball Tickets - Patron Couple (online) (2 included)	$1,000.00	$0.00

Includes: Seating for 2 and name listed in the program

Heart & Stroke Ball Tickets - Table of Eight (online) (8 included)	$2,500.00	$0.00

Includes: Seating for 8 and name listed in the program

Total:

$0.00

Thursday, April 28, 2016
6:30pm - 10:00pm

The Lakeland Center
701 West Lime Street
Lakeland, Florida 33815

General Inquiries
Aileen Gordon
polkAHA@heart.org
(800) 257-6941 x8032

Event Sponsorship Inquiries
Jennifer Helriggle
jennifer.helriggle@heart.org
(770) 612-6061