Inclusive Springfield Partnership Form
Inclusive Springfield consists of community members and leaders that are working together towards the vital efforts to advance our community, as we ensure that all members, regardless of their background, have a voice and a stake in collective progress.
Inclusive Springfield Attestation
*
As a partner, I agree to honor the Inclusive Springfield vision of creating a welcoming community where all people feel they belong and have value.
Is this a new partnership or a renewal?
New Partnership
Renewing Partnership
Business Name
Name
*
First Name
Last Name
Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Which Inclusive Springfield partnership level would you like to purchase? Select one partnership level and then enter the listed amount in the donation box below.
Sustaining Partner ($5,000)
Champion ($2,500)
Collaborator ($1,500)
Advocate ($500)
Supporter ($250)
Please verify that you are human
*
Total Donation Amount
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( X )
USD
Description
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Submit
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