Sponsorship Form
Organization (if applicable)
Contact Name
First Name
Last Name
Mailing Address (Required for Billing)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email (required for billing)
*
example@example.com
Sponsorship level (annually)
*
Diamond ($25,000+)
Platinum ($20,000-$24,999)
Gold ($15,000-$19,999)
Silver ($10,000-$14,999)
Bronze ($5,000-$9,999)
Friends of PACCC ($1,200-$4,999)
Total Funds to Pledge
*
Please indicate how the funds will be dispersed (ie: $5,000 funds , $2,500 in kind, etc) *If in kind, please provide approximate monetary value(s)
*
Based on the level of sponsorship selected, please list the items you have selected as desired deliverables in exchange for sponsorship.
Who from PACCC have you been speaking with?
Submit
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