Sponsorship Form

SAVECENLA Sponsorship Form

Please fill out completely.
Business / Organization Name*
Contact Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you have a logo/website? Please email the logo to info@savecenla.com along with your website address.*

YesNo
Upload Logo Here

Cancelof
If you are interested in having a logo designed, I recommend you to contact design@pc911.com.
Enter your website domain here
Donation Levels*

Partner (4 shirts)Platinum (3 shirts)Gold (2 shirts)Silver (1 shirts)BronzeIn-Kind
Product / Service Contribution
Fair Market Value

Platinum ($2,500 +) (5 Shirts)Gold ($1,000 - $2,499) (4 Shirts)Silver ($500 - $999) (2 Shirts)Bronze ($250 - $499) (1 Shirt)
Enter Shirt Sizes*
Donation Via*

Mailing a check (PO Box 381Invoice Required to Process PaymentCredit Card via PayPal (Payment link will be provided upon submission)
Please verify that you are human*
Please Sign Here*
Thank you for your generous support in helping SaveCenla and other area businesses to lift the stigma of mental illness so that our home can become a suicide-safer community.

SaveCenla Tax ID #81-4863849
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SAVECENLA Sponsorship Form