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• Event Sponsorship Form

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• Event Name*
• Event Date*
• Event Location*
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• Sponsor Name (Business, Organization or Individual)*
• Contact Name*
• Title*
• Phone*

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• Contact Address*

  Street Address 1

  Street Address 2

  City

  State/Province/Region

  Postal/Zip Code

  Country
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• Payment Information

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• Sponsorship Level* Select Platinum - $10,000 Gold - $5,000 Silver - $2,500 Bronze - $1,000 Contributor - $100
• Payment Method*
  Check (Made out to Event Name) Credit Card

  Enter Name on Card, Card Number, Expiration Date
• Signature*
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• Additional Comments
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