Project Partnership Commitment Form

Founding Community Impact Partnership Commitment

Thank you for your interest in becoming a Founding Community Impact Partner with Andrea's Project. Your investment helps prevent impaired driving, educate youth, strengthen communities, and save lives throughout the Texas Panhandle. Founding Community Impact Partners are recognized as inaugural supporters of Andrea's Project's long-term prevention and community safety initiative. Partners receive special Founding Partner recognition, priority renewal opportunities, and year-round visibility throughout their partnership.
Join a select group of organizations investing in long-term impaired driving prevention and community safety throughout the Texas Panhandle.
Organization & Contact Information
Organization Name
Primary Contact Name

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

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Website
Partnership Selection
Which Founding Community Impact Partnership would you like to reserve?
Payment schedule
How would you like to complete your partnership?
Billing contact
Billing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip CodeCountry
Is a purchase order required?
Purchase Order Number
Special Billing Instructions
I understand this submission reserves my organization's Founding Community Impact Partnership. An Andrea's Project representative will contact me to confirm recognition benefits, payment arrangements, and finalize our partnership.
Authorized Representative Signature
Date

MonthDayYear
Date
Billing email
example@example.com
Mailing instructions
Additional Information
Upload Logo

Cancelof
Preferred Social Media Handles or Website
Recognition Name
Is there anything else we should know regarding your partnership, recognition, invoicing, payment, or marketing materials?
Acknowledgment
Should be Empty:

Founding Community Impact Partnership Commitment

Organization & Contact Information

Partnership Selection

Additional Information