Company Name: _______________________________________________________________

Contact Person: _______________________________________________________________

Address:_______________________________________________________

_______________________________________________________________

Web Site:_______________________________________________________

Phone: _______________________ Cell: _______________________

Email:_______________________________________

Level of Sponsorship: (Circle one)

Title Sponsor: $ 7000

Patron Sponsor: $ 2000

Guardian Sponsor: $ 1000

Individual Sponsor: $ 100

In Kind Donations:

Value: __________________

Description:_______________________________________________

___________________________________________________________

Thank you for your support!!!