Clone of BEAM Membership Application

Supporting Membership Application
Select Application Type*

New MembershipRenewal
Organization or Company Name*
Board Representative's Name*

First NameLast Name
Board Representative's Title*
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Fax Number

Area CodePhone Number
Phone Number*

Area CodePhone Number
Please Select Applicable Supporting Membership Fee:*

Society, school, or non-corporate entity $300Company: < 100 employees $600Company: 100-299 employees $850Company: 300-499 employees $1100Company: 500-699 employees $1600Company: 700-999 employees $3000Company: > 999 employees $5000
Sponsorship Opportunities
Select A Sponsorship Opportunity

BEAM Golf Tournament Fundraiser (choose sponsorship level below)BEAM Annual Volunteer Awards Breakfast (choose sponsorship level below)BEAM Club (choose sponsorship level below)
Is your organization able to provide any additional forms of support this membership year?

Use of facilities for meetings or eventsTechnical leaders or other personnel (for running programs or assistance with events)Office supplies / equipment / postagePrizes for fundraising events, student awards, etc.Refreshments for eventsBuses for eventsMaterials for student projectsFundraising outreach or assistanceOther
Pay by Credit Card

If you would like to pay by check, please skip this section and see the next section. Do not fill out this section if you wish to pay by check.

Pay By Check

Everything below this line is optional. Please only complete this section if you wish to support BEAM via check. Please complete all sections as applicable to your sponsorship.
Checks can be made payable to BEAM

Mail Checks To:

BEAM Buffalo
P.O. Box 162
Buffalo NY, 14205
Please Indicate Golf Tournament Sponsorship Level (if applicable)

Gold Sponsor - $1700Silver Sponsor - $1200Bronze Sponsor - $700Hole Sponsor - $100
Please Indicate Volunteer Awards Sponsorship Level (if applicable)

Breakfast Sponsorship with Table - $1000Co-Sponsor with Tabe - $500Bronze Reserved Table (8 People) with Organization Name - $300Individual Supporting Donation - $20
Please Indicate BEAM Club Sponsorship Level (if applicable)

BEAM Club Gold - $1500BEAM Club Silver - $1000BEAM Club Bronze - $500
Individual Donations (if applicable)

Individual Platinum - $1000Individual Gold - $500Individual Silver - $250Individual Bronze - $100
Total of sponsorship values (including membership fee from section 1)
Should be Empty:

Supporting Membership Application