Payment Name(s) (as you wish to be listed in all printed materials) Address City/State/Zip Phone Email © Enclosed is a check for $ © Please charge $ tomy: © MasterCard © Visa Card # Exp. Date: mature © I/We are unable to attend. Enclosed is a contribution of $ Please make your check payable to The Washington Institute, and mail to 1828 L Street NW Suite 1050, Washington, DC 20036, or register online at hetp://www.washingtoninstitute.org/StatesmanRSVP. The W. ) ‘ashingron Lnsticute is a 501(cM3) organization. Your contribution, less $250 per person attending, is tax deductible by law (See htrp: ‘washin_st EFTA00309600

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I wish to participate in the Washington Institute for Near East Policy's ScholarStatesman Award Dinner at the following level: °o President's Table - $100,000 Includes premier seating; two tables (twenty reservations); private reception with photo opportunity; senior VIP at table; opportunity to travel to the Middle East with the Institute; invitation to private briefing; and recognition in the event program. Secretary of State's Table - $50,000 Includes premier seating; one table (ten reservations); private reception with photo opportunity; senior VIP at table; opportunity to travel to the Middle East with the Institute; invitation to private briefing; and recognition in the event program. Ambassador's Table - $25,000 Includes one table (ten reservations); private reception with photo opportunity; invitation to exclusive Washington, D.C., one-day events (past events have been held at the Pentagon, National Counter Terrorism Center, Treasury, and Middle East embassies); and recognition in the event program. Diplomat’s Table - $10,000 Includes one table (cight reservations); invitations to monthly conference calls and regional events with Washington Institute senior fellows; and recognition in the event program. Tickets - $1,000 each (Continned? EFTA00309601