Donor/Sponsor Information
Thank you for supporting the health and wellness of our region's first responders. Questions can be emailed to Heather Grubb at heather@henricosea.com
Primary Contact Person Name
First Name
Last Name
Company Name
Email
example@example.com
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Website or Social Media Links
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I would like a fifteen minute timeslot to address attendees in a private breakout session
Yes
No
I would like more information
I would like an exhibitor space at the Wellness Fair
Yes
No
I would like more information
Sponsorship Levels
$5,000 - Premier Sponsor
$2,500 - Supporting Sponsor
$1,500 - Wellness Advocate
$500 - Friend of First Responders
$250 - Community Ally
In-Kind Donation/Raffle Prize
Other
In-Kind Donations - Please describe items or services
Payment Information
Invoice Me - Invoices will be sent to the contact above unless otherwise noted
I will bring item(s) to the event
Pay with credit card https://www.henricopolicefoundation.org/donate/ Must include "Wellness Summit" in memo
Other
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