Champions for Children Sponsorship Form

Gerald L. Levin Champions for Children 2022 Sponsorship Commitment
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Your contribution is tax deductible for income tax purposes to the extent provided by the Internal Revenue Code. The Federal Tax ID number of Orchards Children's Services is: 38-2712084.
This donation is from*

an Individuala Company (Please provide company name below.)an individual on behalf of a Company (Please provide company name below.)
Please provide your contact information:
Full Name*

First NameLast Name
Company
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
Phone Number*

Area CodePhone Number
Please choose Sponsorship Level and Amount*

Michigan Champion: $25,000Wayne Champion: $15,000Oakland Champion: $10,000Washtenaw Champion: $5,000Macomb Champion: $3,000Genesee Champion: $1,000Individual Tickets: $275Other (Please enter amount in Donation Amount box below.)
For Individual Ticket purchase, please specify number of guests:

Please accept my Sponsorship, Ticket Purchase or Donation in the total amount of:*

USDDonation Amount

Payment Method
Credit	Express
Credit	What is PayPal?

By clicking "Submit" I am confirming my understanding of the contribution commitment I am making to benefit Orchards Children's Services, Champions for Children.
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Gerald L. Levin Champions for Children 2022 Sponsorship Commitment