2014 HOSPITAL BALL CO-CHAIRS
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2 2014 HOSPITAL BALL CO-CHAIRS Badri Nath, MD and Deepti Gupta, MD Ernest Patrick and Susan Smith Aurene C. Alcasabas, MD James Argutto Christine Armanno Deborah A. Aviles, Esq. Steve Barbino Marisa Bisiani DNP, RN, ANP-BC Janet and Frederick C. Braun, III Sean Callahan Kevin E. Conroy Susan Daconto Paul Davin, J.D. Nikki Dougherty Tina Dougherty Vera Tuozzo Esposito Paul Essner Brenda J. Farrell Debi Gaines James Giorgio, Sr. Phyllis Hartmann Susan C. Hever Jason M. Hill COMMITTEE (in formation) Shahriar J. Khalili, MD Bill and Karen Laverty Charlene and William R. Lehmann Anthony Licausi Richard T. and Kathy Margulis Karen R. Maust Kim Mendez, Ed.D., ANP, RN Maureen Mennella Walter G. Metz, Esq. Mark Mulholland, Esq. Karen O Kane, RN, MPA Sharon Norton Remmer Robert Roche, MD Lisa Rose Sally Rose Barbara and Eric Russo Robert and Valerie Schwarz Frank T. Sconzo, MD Gail Steiger, RN, MSN Carolyn Villegas Keisha A. Wisdom, MBA, BSN, RN Randy A. Wolmart
3 Benefiting Memorial Hospital Medical Center Foundation HONORING Nicholas H. Racanelli Racanelli Construction Company, Inc. AND Charles R. Dennis, MD & Hirendra P. Sinha, MD Co-Recipients of the Dr. Jacob Dranitzke Award Saturday, November 15, 2014 Cocktails at 7:00 p.m. Dinner and Dancing at 8:00 p.m. East Wind 5720 Route 25A Wading River, NY Black Tie Mask Optional
4 Brookhaven Memorial Hospital Medical Center Proudly Recognizes Our Corporate Partners Who Are Sponsors for All of Our Events: PLATINUM Emergency Ambulance Service Randy Wolmart DIAMOND Knapp Swezey Foundation Lisa Rose GOLD B&G Industries, Ltd. James Giorgio, Sr. Brookhaven Health Care Facility Debi Gaines PATRON The Amato-Waldbauer Group UBS Financial Services BDO USA, LLP Fumuso, Kelly, DeVerna, Snyder, Swart & Farrell, LLP Mullooly, Jeffrey, Rooney, & Flynn LLP Damianos Realty Group LLC Cristofer, John, and Pelops Damianos Racanelli Construction Company, Inc. Nicholas H. Racanellis TSG Financial, LLC Paul Essner and Michael Waters TD Bank BRONZE Kerley, Walsh, Matera & Cinquemani, PC Putney, Twombly, Hall & Hirson LLP Daniel F. Murphy, Jr. and Mary Ellen Donnelly Wiedersum Associates Architects CHAMPION Capital One Bank Lewis Johs Avallone Aviles, LLP Deborah A. Aviles and Frederick Johs Route 112 Office Campus Mark Rose and Geppie Celauro SUPPORTER People s United Bank Swezey Fuel Co. Inc. TRITEC Real Estate Company, Inc. Tritech Healthcare Management, LLC FRIEND Lakeview Rehabilitation and Care Center Oak Hollow Nursing Center Spectrum Physical Therapy To become a Corporate Partner, please contact Stephanie Sciara at or ssciara@bmhmc.org Brookhaven Memorial Hospital Medical Center 101 Hospital Road Patchogue, New York hospitalball@bmhmc.org
5 Please respond on or before November 6, We would like our listing to read: Our Guests/Seating Request: MAKE A NIGHT OF IT As a courtesy to our guests, Brookhaven Memorial Hospital Medical Center has made arrangements to secure rooms at the East Wind Inn and Spa at a special rate of $169 per room for the night of the event. We have a limited number of rooms available on a first-come, first-served basis. Sunday Brunch will also be available to our guests at a special rate of $14.95 per person. For more information or to make a room reservation, contact The East Wind at by November 6, 2014.
6 SPONSORSHIPS & TICKETS All monies raised by the Hospital Ball will help fund the construction of new cardiac and operating suites and the programs and services associated with them. Brookhaven Memorial Hospital has received a challenge grant that will match the net proceeds of this event. PLATINUM - $50,000 Includes: Prominent seating for three tables of ten, special recognition at the Ball, prominent listing in program, and VIP Reception. GOLD - $25,000 Includes: Prominent seating for two tables of ten, special recognition at the Ball, prominent listing in program, and VIP Reception. SILVER - $15,000 Includes: Prime seating for one table of ten, recognition at the Ball, prominent listing in program, and VIP Reception. BRONZE - $10,000 Includes: Choice seating for one table of ten, recognition at the Ball, and prominent listing in program. PEWTER - $6,000 Includes: Six dinner tickets, recognition at the Ball, and prominent listing in the program. ADDITIONAL SPONSORSHIPS I am pleased to be able to support the Hospital as a sponsor of the Hospital Ball. Please include my name in the program for the evening. CHAMPION- $2,500 BENEFACTOR- $2,000 PATRON - $1,500 SUPPORTER- $1,000 FRIEND- $500 DONOR- $250 TICKETS Please reserve tables of ten at $5,000 per table. Please reserve tickets at $500 per ticket. I am unable to attend. I/We would like to make a contribution of $ to the BMH Foundation. Name _ Title/Company Address City/State/Zip Telephone Fax We have enclosed a check for $ payable to the BMH Foundation in support of its programs and services. Please bill my credit card for $ Amex Visa MasterCard Credit Card # Exp. Date Security Code Signature Name (as it appears on card) Please return this form with your materials and payment to: Development Office Brookhaven Memorial Hospital Medical Center 101 Hospital Road Patchogue, New York Telephone: hospitalball@bmhmc.org BMH Foundation is a tax-exempt 501 (c) 3 organization. Tax ID# PLEASE RESPOND ON OR BEFORE NOVEMBER 6, 2014
7 Brookhaven Memorial Hospital Medical Center 101 Hospital Road Patchogue, New York 11772
HOSPITAL BALL CO-CHAIRS
HOSPITAL BALL CO-CHAIRS Mark and Rosanne Mulholland Badri Nath, MD and Deepti Gupta, MD COMMITTEE (in formation) John Abreu Aurene C. Alcasabas, MD James Argutto Deborah A. Aviles, Esq. Steve Barbino Marisa
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