Cash/Check Payments Cash/Check Payments How much is the donation? Is this gift in honor or memory of someone?Select OneYesNoIs this gift in honor or memory, if so choose below:In memory ofIn honor ofName of person in honor of / memory of Merchandise2024 Vineyard Vines Tie – Men's Quantity Price: $88.00 Quantity 2023 Vineyard Vines Tie – Men's Quantity Price: $80.00 Quantity 2022 Vineyard Vines Tie-Men's Quantity Price: $70.00 Quantity 2020 Carnival Memphis Tie – Men's Quantity Price: $60.00 Quantity 2019 Carnival Memphis Tie – Men's Quantity Price: $60.00 Quantity Socks – Striped Quantity Price: $20.00 Quantity Socks – Carnival Crest Quantity Price: $20.00 Quantity Cosmetic Bag Quantity Price: $60.00 Quantity Anniversary Vineyard Vines Tie & Cummerbund Quantity Price: $110.00 Quantity Anniversary Vineyard Vines Tie & CummerbundAnniversary Vineyard Vines Ladies Scarf Quantity Price: $80.00 Quantity Anniversary Vineyard Vines Ladies Scarf 2015/2017 Carnival Memphis Bow Tie – Men's Quantity Price: $50.00 Quantity 2016 Anniversary Vineyard Vines Tie – Boy's Quantity Price: $50.00 Quantity Special 85th/50th Anniversary Vineyard Vines Tie2017 Vineyard Vines Tie – Boy's Quantity Price: $50.00 Quantity 2018 Carnival Memphis Tie in Peach – Boy's Quantity Price: $50.00 Quantity 2019 Carnival Memphis Tie – Boy's Quantity Price: $50.00 Quantity Vineyard Vines Carnival Memphis 2017 Tie – Men's Quantity Price: $80.00 Quantity EventsKrewes for Kids Tickets Quantity Price: $125.00 Quantity Krewes for Kids SponsorshipsSelect OneDiamond – $15,000Platinum – $10,000Gold – $5,000Silver – $2,500Bronze – $1,500Supporting – $550B & I Tickets Quantity Price: $55.00 Quantity B & I Table (10 Tickets) Quantity Price: $550.00 Quantity B & I Tickets – Alumni Membership Quantity Price: $45.00 Quantity B & I Table Sponsorship Quantity Price: $1,000.00 Quantity Crown & Sceptre – Members Quantity Price: $225.00 Quantity Crown & Sceptre – Non-Members Quantity Price: $275.00 Quantity Princess Ball Quantity Price: $80.00 Quantity Princess Ball – Alumni Membership Quantity Price: $55.00 Quantity FeesRoyal Court InformationPrincess First Name: Princess Last Name: High School: College: Cell Phone:Princess Email: Mother's Name First Last Parent's Full Formal Name If parents are divorced, provide Full Name of 2nd parent Additional Parent Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCĂ´te d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRĂ©unionSaint BarthĂ©lemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTĂĽrkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweĂ…land Islands Country Paying Royal Court Fee in Full Royal Court Fee Quantity Price: $4,200.00 Quantity Paying Royal Court Deposit Royal Court Deposit Quantity Price: $600.00 Quantity Royal Court 1st Payment Quantity Price: $1,300.00 Quantity Royal Court 2nd Payment Quantity Price: $1,300.00 Quantity Royal Court 3rd Payment Quantity Price: $1,300.00 Quantity Escort Fee Quantity Price: $250.00 Quantity Page Fee Quantity Price: $2,100.00 Quantity Scarab Fee Quantity Price: $2,100.00 Quantity Junior Court Quantity Price: $425.00 Quantity Non Profit Member Quantity Price: $250.00 Quantity Board Dues Quantity Price: $650.00 Quantity Board Dues Plus Quantity Price: $1,000.00 Quantity Alumni Membership-Individual Quantity Price: $25.00 Quantity Alumni Membership-Couple Quantity Price: $50.00 Quantity Krewe Royalty Package A Quantity Price: $475.00 Quantity Ptolemy Krewe Royalty Package A Quantity Price: $400.00 Quantity Krewe Royalty Package B Quantity Price: $950.00 Quantity Are you a member of a Grand Krewe? Yes No Grand Krewe AffiliationEnneadLuxorMystic Society of the MemphiOsirisPhoenixPtahPtolemyRaMetRoyal Society of Queen BeesSphinxAre You a Non-Profit Member? Yes No Non-Profit Organization Are You a Board Member? Yes No Board Member Position I've Chosen The Following Membership Diamond – $2500 Gold – $1,200 Silver – $750 Bronze – $300 Family – $150 Individual – $75 Family Grand Krewe-$100 (Savings $50) Individual Grand Krewe-$50 (Savings $25) Name* First Last Billing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email PhoneAmount*Donation Amount Payment TypeCashCheckCredit CardCheck NumberCheck Date MM slash DD slash YYYY Total $0.00 Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Expiration Date Security Code Cardholder Name
