Friends of Michael Sponsorship

Friends of Michael Sponsorship

Please complete all required fields.
Sponsor Contact Information
Name*

First NameLast Name
Email Address*
example@example.com
Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Organization Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Sponsorship Level Selection
Sponsorship Level*

$25,000 - Jerry Garcia$15,000 - John Mayer$10,000 - Eric Clapton$5,000 - Tom Petty$3,000 - Stevie Ray Vaughn$1,500 - Derek Trucks$1,000 - Joe Bonamassa$500 - Mike Campbell$250 - Joe Walsh
Payment or Pledge Details
Mail in the form with a check payable to:
‍The Michael E. Simmons Foundation
Attn: Linda Champagne
P.O. Box 281041
East Hartford, CT 06128
Should be Empty: