Vines for Vision Sponsorship Form

Vines for Vision - Sponsorship Commitment Form

Presented by Eye Surgeons International - "We See a World Without Blindness"

Thank you for supporting the inaugural Vines for Vision fundraising dinner, Thursday, October 9, 2025, at the historic V. Sattui Winery in St. Helena, California. Your sponsorship directly supports our mission to eliminate avoidable blindness, starting with a new teaching hospital and clinic in rural Zambia.

Business or Organization

Contact Person*

City

Street Address

Zip Code

State

Phone*

Email*

example@example.com

Sponsorship Level (select one)*

Presenting Visionary Sponsor: 1 Table (10 guests) - $25,000Supporting Visionary Sponsor: 1 Table (10 guests) - $15,000Partner Visionary Sponsor: 1 Table (6 guests) - $10,000Helping Visionary Sponsor: 1 Table (4 guests) - $5,000

Guest List (you may submit later if not confirmed)

Guest 1

Guest 2

Guest 3

Guest 4

Guest 5

Presenting Visionary and Supporting Visionary

Guest 6

Presenting Visionary and Supporting Visionary

Guest 7

Presenting Visionary

Guest 8

Presenting Visionary

Guest 9

Presenting Visionary

Guest 10

Presenting Visionary

Checks only. Please make checks payable to: Eye Surgeons International Mail to: Vines for Vision 4026 Tall Grass Dr. Napa, California 94558

I confirm my sponsorship commitment and understand that payment is by check only.