SPONSOR COMMITMENT FORM
End With Red Gala: Life in Full Bloom | March 8th, 2025
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Sponsor Name (as you would like to be listed)
*
Main Contact
*
First Name
Last Name
Title
*
Phone Number
*
Format: (000) 000-0000.
Email
*
example@example.com
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Billing Information (if different than above)
Contact Name
First Name
Last Name
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Sponsorship Confirmation
Level of Sponsorship
*
$50,000 - Presenting Sponsor
$25,000 - Full Bloom Sponsor
$10,000 - Orchid Sponsor
$5,000 - Lotus Sponsor
$2,500 - Rose Sponsor
In-Kind Donation
In-Kind Donation: Total Estimated Value
In-Kind Donation: Provide a detailed description of the product or service.
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Would you like to donate part or all of your table to womxn living with HIV? If yes, please list how many tickets you'd like to donate.
Payment Information
Payment Instructions
Upon submission of the Sponsorship Commitment Form, an invoice will be emailed to the main or billing contact. Make checks payable to: The Afiya Center, 4373 S. Hampton Rd, Dallas, TX 75232. All payments are due in full by February 21, 2025.
Payment Amount
*
Payment Method
*
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ACH Electronic Bank Transfer
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Authorized Signature
*
Date Signed
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Month
-
Day
Year
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