Circle of Life Children\'s Center Inaugural Golf Outing Brochure Sept. 20, 2010 Basking Ridge, NJ

1. registration Form
CIRCLE OF LIFE CHILDREN’S CENTER, INC. q Individual Golfer q Foursome q Sponsor* q Dinner Only
Foursome Names:
Compassionate Care and Family Support for Seriously Ill Children ____________________________________________________
Circle of Life Children’s Center, Inc. (COLCC) is a care are limited in their resources and rely on good will ____________________________________________________
501(c)(3) nonprofit corporation, currently in its fifth year and philanthropy to keep their programs running. The
care provided by Circle of Life to children living with ____________________________________________________
of providing programs and services to infants, children
and adolescents who are seriously ill and their families heartbreaking illness is not readily available to most ____________________________________________________
through our Pediatric Palliative Care Team comprised children, and their families are caught in the maelstrom
of a Medical Director, Neonatologist, APRN, RN, and of the current medical system. These simple measures q (I/we) are unable to attend, but enclose our tax-deductible
Bereavement Coordinator. reduce pain and suffering while addressing overall needs gift of: $ __________________________________________
including bereavement support for surviving family
The mission of COLCC is to provide a comprehensive members. q Enclosed is: $ _____________________________________
program of palliative and end of life care for infants and
Proceeds from this event support Circle of Life, including q Credit Card Type: ________________ Exp. Date__________
children with chronic and life-limiting illnesses and their
families. in-patient, home-care programs, end-of-life family support Name On Card _______________________________________
and bereavement services, and their ultimate goal of a
Currently, pediatric palliative care and the support freestanding, homelike facility for children and families Card # ______________________________________________
provided by Circle of Life to families is not a service where sensitive, compassionate end-of-life and respite
reimbursed by state or private insurance programs. care can be provided in a warm, friendly, supportive make checks payable to Circle of Life Children’s Center
Programs dedicated to children in this sensitive area of environment. and mail check and registration form to:
Circle of Life Children’s Center, Inc.
274 South Orange Avenue, Newark, New Jersey 07103
Name ___________________________________________
Company Name ___________________________________
Address __________________________________________
________________________________________________
Telephone ________________________________________
Email ____________________________________________
registration deadline is august 1, 2010
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events sCheduLe
11:00 am – 12:30 pm
Registration/Lunch
12:30 pm
Shotgun Start
5:30 pm
Cocktails, Dinner, Awards, Prizes,
Auction and 50/50 Raffle
6:30 pm
Dinner
*Please mark desired sponsorship level on reverse side.

2. sPonsorshiP LeveLs Board oF trustees
q Platinum sponsor – $15,000 robert J. trobe
Managing Director,
Includes 2 foursomes, 2 exclusive green signs, name/logo Frank Crystal & Company (NYC)
on gift bag, banner listing, program back cover and lunch, marc C. Wuensch, CPa
cocktails, dinner for each member of foursome Liebgold, Wuensch & Assoc.
James m. oleske, md, mPh
q gold sponsor – $12,000 Medical Director,
Includes 2 foursomes, 1 exclusive green sign, name/logo FXB Center for Children – UMDNJ
on gift bag, banner listing, program inside front cover,
Jeffrey h. Bunin, Bche, mBa First Annual
goLF
Bunin Management Advisors, LLC
lunch, cocktails, dinner for each member of foursome scott d. shapiro, CPa
Weber, Shapiro & Co., LLP
q silver sponsor – $10,000 richard h. Bernstein, md, FaCP
outing
Includes 1 foursome, 1 exclusive green sign, name/logo Chief Medical Director,
VNS CHOICE
on gift bag, banner listing, program, inside back cover, gina m. dunsmuir, esq.
and lunch, cocktails, dinner for each member of foursome Assistant General Counsel, Compliance
C. R. Bard, Inc.
q Bronze sponsor – $7,500 onajovwe Fofah, md. FaaP
Includes 1 foursome, poster recognition, full page ad in Assistant Professor of Pediatrics
Division of Neonatology, UMDNJ
Monday, September 20, 2010
program and lunch, cocktails, dinner for each member
William J. Kroll
of foursome Chairman & CEO Basking Ridge Country Club
q dinner sponsor – $5,000
Matheson Tri-Gas
Joel markel Basking Ridge, NJ
Includes individual poster and group sponsor poster, President & CEO
2 guests for cocktails and dinner, full page ad in program Preferred Healthmate, Inc. 11:00 am Registration
margaret J. mcLean, CFre
Fundraising Consulting and 12:30 pm Shotgun Start
q Cocktail sponsor – $3,000 Research Information Services
Includes individual poster and group sponsor poster, richard d. Purcell, Jr.
2 guests for cocktails and dinner; half page ad in program President
DNA Healthlink, Inc.
q Lunch sponsor – $2,000 michael F. schaff, esq.
Chair, Corporate & Health Care Departments
Includes individual poster and group sponsor poster, Wilentz, Goldman & Spitzer, P.A.
half page ad in program
goLF Committee
q golf Cart sponsor - $1,500
Includes half page ad in program Jeff duncan
Duncan Financial Services, LLC
Joseph a. Boyle, esq.
q awards sponsor – $1,000 Kelley, Drye & Warren
Includes half page ad in program gina m. dunsmuir, esq.
C. R. Bard, Inc.
q Photography sponsor – $1000 Paul Foley
Includes half page ad in program Lee Nolan Associates
margaret J. mcLean, CFre
Fundraising Consulting
q gift Bag sponsor – $1000 John nieradka
Includes: half page ad in program Matrix Healthcare Services
scott d. Pollack, aams
q Program sponsor – $750 Pollack Financial Group, LLC
david umbria
Lee Nolan Associates
q exclusive green sponsor – $500 Kenneth Zuckerberg
Carlan Associates, LLC
q hole sponsor – $250
Norma Godin Millison, Executive Director
q individual golfer – $300
Circle Of Life Children’s Center, Inc.
Includes golf, lunch, cocktails, dinner 274 South Orange Avenue I Newark, New Jersey 07103
Tel: 973-273-0872 I Fax: 973-273-0873
q Cocktails and dinner only – $100 per person www.circleoflifenj.org