Saturday, October 20, :00PM

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1 Proudly Recognizes Our Foundation Partners DIAMOND SPONSORS Knapp Swezey Foundation Lisa Rose Ric and Sally Rose PLATINUM SPONSORS Brookhaven Health Care Facility Debi Gaines Emergency Ambulance Service Donaldson s Subaru GOLD SPONSORS Damianos Realty Group Cristofer, John and Pelops Damianos Progessive Emergency Physicians Swezey Fuel Company, Inc. TD Bank SILVER SPONSORS TSG Financial, LLC Paul Essner and Michael Waters The Amato-Waldbauer Group UBS Financial BRONZE SPONSORS Kerley, Walsh, Matera and Cinquemani, PC People s United Bank Maureen Mennella Precision International Putney, Twombly, Hall & Hirson LLP Saturday, October 20, :00PM East Wind Long Island Wading River, New York CHAMPION SPONSORS Fumuso, Kelly, Swart, Farrell, Polin and Christesen LLP Lewis Johs Avallone Aviles, LLP Route 112 Office Campus Mark Rose and Geppie Celauro PATRON SPONSORS Affinity Skilled Living Rehabilitation Center McPeaks Assisted Living Mullooly, Jeffrey, Rooney & Flynn, LLP Tritech Healthcare Management, LLC 101 Hospital Road, Patchogue, NY Online registration at presented by

2 The Harvest Moon Gala Gala Co-Chairs Lisa and William Kruger, MD Toni and John Sullivan Gala Committee Kym Carpentieri, MD Kathy and Tom Cullen Henri Delbeau, MD Louise Ebert Paul Essner Brenda Farrell Janet and Michael Foster Debi Gaines Ravi Gupta, MD Brian Lee, MD Badri Nath, MD David Mangiameli, MD Richard T. Margulis Karen Maust Maureen Mennella Abbie Moloney Clyde Parker Sherri Paxson Robert Roche, MD Robin and Pete Roe Charles Rothberg, MD Kim and Frank Sconzo, MD Satyanarayana V. Tanguturi, MD Wehbeh Wehbeh, MD Randy Wolmart Diane and Gary Zanazzi

3 join us on October 20 th for Honoring the Vision and Legacy of our Founders and Inspiring a Courageous Future Introducing And The John White Community Leadership Award Making a Difference and Promoting Excellence in Healthcare Recognizing Nabil Kiridly, MD Recipient of the Dr. Jacob Dranitzke Award East Wind Long Island 5720 Route 25A Wading River, New York 6:00PM cocktails Elegant Attire

4 Proudly Recognizes Our Foundation Partners DIAMOND SPONSORS Knapp Swezey Foundation Lisa Rose Ric and Sally Rose PLATINUM SPONSORS Brookhaven Health Care Facility Debi Gaines Emergency Ambulance Service Donaldson s Subaru GOLD SPONSORS Damianos Realty Group Cristofer, John and Pelops Damianos Progessive Emergency Physicians Swezey Fuel Company, Inc. TD Bank SILVER SPONSORS TSG Financial, LLC Paul Essner and Michael Waters The Amato-Waldbauer Group UBS Financial BRONZE SPONSORS Kerley, Walsh, Matera and Cinquemani, PC People s United Bank Maureen Mennella Precision International Putney, Twombly, Hall & Hirson LLP Saturday, October 20, :00PM East Wind Long Island Wading River, New York CHAMPION SPONSORS Fumuso, Kelly, Swart, Farrell, Polin and Christesen LLP Lewis Johs Avallone Aviles, LLP Route 112 Office Campus Mark Rose and Geppie Celauro PATRON SPONSORS Affinity Skilled Living Rehabilitation Center McPeaks Assisted Living Mullooly, Jeffrey, Rooney & Flynn, LLP Tritech Healthcare Management, LLC 101 Hospital Road, Patchogue, NY Online registration at presented by

5 Name Title/Company Address City/State/Zip Phone Guest(s) Names We have enclosed a check for $ payable to the BMH Foundation Please bill my credit card for $ American express Visa MasterCard Discover Credit Card # Exp. Date Security Code Signature Name (as it appears on the card) Please return this form to: Development Office 101 Hospital Road, Patchogue, New York Telephone: ALL PROCEEDS WILL GO TO PROGRAMS AND SERVICES AT LONG ISLAND COMMUNITY HOSPITAL Online registrations go to PLEASE RESPOND ON OR BEFORE OCTOBER 12, 2018 BMH Foundation is a tax-exempt 501 (c) 3 organization. Tax ID# All donations are tax deductible as permitted by law.

6 SPONSORSHIPS AND TICKETS Harvest Moon - $50,000 Reserved VIP seating for twenty four guests, special recognition at the Gala, a full-screen e-journal ad, and a full-screen ad on the Gala event website. Full Moon - $25,000 Reserved VIP seating for sixteen guests, special recognition at the Gala, a full-screen e-journal ad, and a full-screen ad on the Gala event website. Crescent Moon - $15,000 Reserved seating for ten guests, special recognition at the Gala, a full-screen e-journal ad, and a full-screen ad on the Gala event website. New moon - $10,000 Eight Gala tickets, a half-screen e-journal ad, and a half-screen ad on the Gala event website. half-moon - $6,000 Six Gala tickets, a quarter-screen e-journal ad, and a quarter-screen ad on the Gala event website. moon Beam - $3,500 Four Gala tickets and a quarter-screen e-journal ad. Moon Stone - $2,000 Two Gala tickets and a greeting (one line, plus name) in the e-journal. INDIVIDUAL TICKETS - $500 Please reserve ticket(s) at $500 per guest. JOURNAL ADS FULL SCREEN - $3,000 Recognition with a full-screen e-journal ad on the Gala website and at the Gala. HALF SCREEN - $2,000 Recognition with a half-screen e-journal ad on the Gala website and at the Gala. QUARTER SCREEN - $1,000 Recognition with a quarter-screen e-journal ad at the Gala. GREETING - $500 Recognition with a greeting (one line, plus name) at the Gala. LISTING - $250 The Ad should read: I/We would like to make a contribution of $ to the BMH Foundation.