Sponsorship Form

Credit Card Information

Cardholder Name (Required)

Credit Card # (Required)

Expiration Date (Required)

Security Code (Required)

cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

Cover the fee associated with this online transaction?

Yes, I will pay an additional {transaction_fee} to cover the cost of this transaction.

Cover the fee associated with this online transaction?

Your total payment will be

Your credit balance will cover

Your credit card will be charged

Your bank account will be charged

Sponsorship Form

We thank you for your support as a sponsor for our Reopening Gala! Please submit the following form by March 31, 2024, to receive our full listing of benefits.

Name for Recognition Purposes: (Required)

Contact Name:

First Name *

Last Name *

Address:

Country

Address Line 1 *

City *

State/Province *

Postal Code *

Phone: (Required)

Email: (Required)

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Sponsorship Level: (Required)

I am not able to contribute as a sponsor, but please accept my donation of...