Join us October 6th!

Join us for a night of celebration and support Citizen Action of New York's work to get money out of politics and transform New York into a true democracy! We're honoring the ordinary people who, through community organizing & civic engagement, have demonstrated extraordinary power in expanding democracy in our communities.

Honoring

DeNora Getachew

Melody Lopez

trellis stepter

Ricky Silver

Special Tribute

Frontline union health care workers of New York

Please use the form below to register. Regsitering through this form will automatically regsiter you for the virtual event in Zoom. If you have any questions about the event please contact Andrew at gala@citizenactionny.org.

Checks can be mailed to Citizen Action of New York, c/o Andrew Tarwerdi, 94 Central Ave, Albany, NY 12206 along with the form at this link.

If you would like to make a tax-deductible contribution to the Public Policy & Education Fund of New York, please click here.

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Contact Information

First Name Last Name

Street Address

Postal Code City State/Province

Email Home Phone (Optional) Mobile Phone (Optional)

By submitting your cell phone number you are agreeing to receive periodic text messages from this organization. Message and data rates may apply. Text HELP for more information. Text STOP to stop receiving messages.

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(Optional)

Event Registration

Levels marked with a * are Host Committee levels and include listing in the invitation and electronic journal. Deadline for listing is Tuesday, September 15.

To see the ad levels or purchase an ad only, please click here.

The deadline for electronic journal ads is Tuesday, September 29.

Ad size is 10"w x 7.5"h. Submit as PNG, JPG or PDF file to gala@citizenactionny.org.

Ticket Level		Quantity
Activist Ticket ($300) 1 ticket to the reception		`Number of Activist Ticket tickets ($300 each)`
Resistor* ($500) 1 ticket and recognition in the electronic journal		`Number of Resistor* tickets ($500 each)`
Advocate* ($1,500) 2 tickets and a Bronze electronic ad		`Number of Advocate* tickets ($1,500 each)`
Organizer* ($3,000) 4 tickets and a Silver electronic ad		`Number of Organizer* tickets ($3,000 each)`
Innovator* ($5,000) 5 tickets and a Gold electronic ad		`Number of Innovator* tickets ($5,000 each)`
Movement Builder* ($10,000) 10 tickets and a Platinum electronic ad		`Number of Movement Builder* tickets ($10,000 each)`
Leader of the Resistance* ($15,000) 15 tickets and a Platinum electronic ad		`Number of Leader of the Resistance* tickets ($15,000 each)`
Champion for Change* ($30,000) 25 tickets, a Diamond electronic ad and recognition from the podium		`Number of Champion for Change* tickets ($30,000 each)`
Additional Contribution (Optional)
TOTAL: $0		QTY: 0

Additional Information

Please list the name of the sponsoring organization, if applicable. (Optional)

Please list the names and emails of the attendees who will be using your tickets, including yourself if applicable. (List "N/A" if no one is attending.)

For Host Committee members: please provide the name exactly as it should be listed on the program. (List "N/A" if not applicable.)