Buddy Walk 2011 Sponsorship Form

Sponsor Registrations Due By October 1, 2011

 

Sponsorshop Info

Tell us about yourself

Please tell us how we can contact you should the need arise.  We will not share your information with anyone without your prior conscent. We use your contact information solely as a means of keeping you informed.

Business/Organization Name

Contact Name

Street Address

City

State

Zip Code

Phone Numbers

Please tell us about the best way to reach you by phone. GCDSS will not share or sell your phone numbers with anyone....ever.

Primary Phone

Secondary Phone

Email Address

Please tell us about the best way to reach you by email. GCDSS will never share you email address with anyone, ever (we hate spam too).

Email Address

Email (Verify)

Sponsorship Type

Become a GCDSS Sponsor


Yes, I would like to participate as a sponsor .


Check below which level you commit to provide GCDSS, Inc. in support of its mission.  Corporate sponsors will be recognized on the back of the t-shirts as well as logo's for the Title sponsors.  To be included on the t-shirts, signs, and pre-walk publicity - your sponsor request must be received by October 1, 2011.

Select a Sponsorship Level


Bronze - $100.00
Silver - $250.00
Gold - $500.00
Platinum - $1000.00
Title - $2500.00

 

I am unable to participate as a sponsor, but I would like to participate as a:

Friends & Family Supporter - $75.00
Other - Amount   $ 

 

Payment Method

Please tell us how you would prefer to make your donation. Further instructions will follow once you submit the form.
I will make my donation on-line with PayPal.
I will send in my donation via a check or money order.

 


In Kind Service

Donation of in-kind service in the place of a monetary donation. Please provide a description and value of items (or services) to be donated.

In-Kind Service Donation

In-Kind Services Description

In-Kind Services Value

Questions?

If you have questions

Should you have any questions, please contact Kim Duffy at (228) 623-3331 or Cindy Hansen at (228) 323-7654 or via e-Mail at gcdss@cableone.net.