Celebration of the Century - EVENT SPONSORSHIP PAYMENT
PRIMARY NAME
*
First Name
Last Name
Organization Name (If applicable)
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I/We authorize HEAR Wisconsin to include our corporate, foundation, or family name and/or logo on materials relevant to our sponsorship level. (Please upload a hir-res jpeg or png file of your logo below)
YES
Sponsorship Level
Legacy Leader - $100,000
Centennial Visionary - $50,000
Community Trailblazer - $25,000
Connection Ambassador - $10,000
Access Champion - $5,000
Impact Amplifier - $3,000
Team Spirit - $8,000
Quantity of Sponsor Level
*
Total (Includes a 3.5% Credit Card Fee - calculated automatically)
*
My Payment
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USD
Total Sponsorship Amount (Includes 3.5% CC Fee)
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please upload your logo here.
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