Sponsorship Form - Two Paws Up

Sponsorship Form - Two Paws Up - $5,000
ACTS -Assistance Canine Training Services
2928 East Conway Road
Center Conway, NH 03813
603-383-2073
info@assistancecanine.org
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Date*

MonthDayYear
Date
Contact Name*

First NameLast Name
This Sponsorship is a

Corporate or Non-Profit SponsorshipIndividual Sponsorship
Company Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone*

Area CodePhone Number
Cell Phone

Area CodePhone Number
Work Phone

Area CodePhone Number
Email*
example@example.com
Donation
My Sponsorship Donation*

Will be sent in one check for $5,000Will be sent in two installments of $2,500 eachOther
Please specify the intended dates of your installments.*
Please make checks payable to ACTS.

Mail to:

ACTS
2928 East Conway Road
Center Conway, NH 03813
I acknowledge that by submitting my name and signing below, that all the above information is accurate.
Name*

First NameLast Name
Please Sign and Submit*

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Sponsorship Form - Two Paws Up - $5,000