Sponsor's Full Name

Contact Person

First Name

Last Name

Primary Phone

(###)

###

####

Cell / Secondary Phone

(###)

###

####

Email Address

Sponsorship Level

Bronze Sponsor

Silver Sponsor

Gold Sponsor

Sponsorship Contribution

Please indicate your intended sponsorship contribution

Cash/Money

In Kind Services

Not sure/can't decide

Sponsor logo will be provided by:

High-resolution logos in JPEG format. We will contact you to get the logo from you.

Sponsor

Other

Don't have a logo

Sponsor Signature or Designate

To sign the form, please type your name in full

Date

YYYY

Thank you for your interest in becominig a sponsor. Someone will contact you shortly.