Annual Gala Benefit 2025 : Tribute to Guylaine Tremblay

Formulaire de réservation-EN

Tribute to Guylaine Tremblay

Wednesday 28, May 2025
5 pm : Cocktail
6: 30 pm : Dinner and Show

By contributing to the 2025 Théâtre ESPACE GO fundraising campaign, you are supporting our unique mission : to give life to the imaginations of women artists.

RESERVATION FORM

TABLE

We would like to reserve a table for eight (8) people at $15,000. Two artists will join you and your guest.

Please reserve our table(s) under the name(s)

A tax-deductible receipt will be issued for the eligible amount of the donation.

RECOGNITION AND THANKS

Name(s) to appear in the program

This is an anonymous donation.

CONTACT INFORMATION

Personal Contact Information

Office Contact Information

Mr.

Ms.

Mx.

Other

First Name

Title

Address

Province

Telephone

Arranged by

Last Name

Company

City

Postal Code

CONTACT PERSON

Mr.

Ms.

Mx.

Other

First Name

Telephone

Last Name

PAIEMENT TYPE (Credit card or check)

Credit Card

Check

CREDIT CARD

MasterCard

Visa

Card Number

Month

Year

CVV/CVC

Name appearing on the credit card

Company name that appears on the credit card (if applicable)

Please bill me immediately

Please bill me on the following date

Day

Month

Year

CHECK

Please send your check, made out to ESPACE GO Inc., and the reservation form to the following address :

ESPACE GO
4890, boulevard Saint-Laurent
Montréal (Québec) H2T 1R5

Please bill me immediately

Please bill me on the following date

Day

Month

Year

TAX-DEDUCTIBLE RECEIPT

Would you like to receive a tax receipt, which will be mailed in the fall of 2025?

Yes

A tax receipt can only be issued in the name of the true donor, that is the individual or organization making the donation. For foundations, we can issue a document attesting to the donation.

Type of donation

Personal

Corporate

To what address would you like your tax receipt to be mailed, if that address is different than the one that
appears above?

True Donor

Address

Province

City

Postal Code

ESPACE GO is a registered charitable organization (123092686RR0001). This campaign is eligible to be part of the Quebec government’s Mécénat Placement Culture programme, which will match all donations once the theatre is authorized. This revenue will be capitalized for a minimum of ten years.

INFORMATION

Luc Chauvette | Director of communications and marketing
514 845-5455, extension 204 | lucchauvette@espacego.com

Annual Gala Benefit 2025 : Tribute to Guylaine Tremblay

Tribute to Guylaine Tremblay

By contributing to the 2025 Théâtre ESPACE GO fundraising campaign, you are supporting our unique mission : to give life to the imaginations of women artists.

RESERVATION FORM

TABLE

RECOGNITION AND THANKS

CONTACT INFORMATION

CONTACT PERSON

PAIEMENT TYPE (Credit card or check)

CREDIT CARD

CHECK

TAX-DEDUCTIBLE RECEIPT

INFORMATION

Soirée-bénéfice 2025 : Hommage à Guylaine Tremblay