NMD Sponsor's Registration Form

Sponsor's Registration Form

Submit separate forms for each candidate you are sponsoring
Candidate' Name*

First NameLast Name
Sponsor's Name*

First NameLast Name
Sponsor's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Sponsor's Phone Number*
Type

LandlineMobile
Sponsor's E-mail
example@example.com
What are your reasons for recommending this candidate?
To your knowledge, does this candidate have any physical or emotional needs that would affect participation on a DeColores weekend of which we should be aware?

YesNo
If yes, please explain
Which qualities best describe your candidate? Check all that apply

ShyOutgoingQuietTalkativeLeaderFollower
I have read the Sponsor's Duties & Responsibilities form. I am familiar with the qualifications and responsibilities of a sponsor and I am prepared to accept these obligations. I will pay below by credit card OR mail a check for the $15 fee to:

DeColores Registration

3573 Dock Rd

Williamsburg, MI 49690
Date

MonthDayYear
Date

Fee Payment

Sponsor's Fee for Candidate: Includes $1 service fee to cover payment costs.

$16.00 Quantity