4th Annual Gala Sponsorship Request Form
Company Name
Contact Person
Contact Email
Contact Phone Number
Address
City, State, ZIP Code
Will you be attending gala?
Yes
No
Sponsorship Levels
Educator Level
$
5,000.00
Quantity
1
2
Scholar Level
$
3,000.00
Quantity
1
2
Fellow
$
1,000.00
Quantity
1
2
Mentor
$
750.00
Quantity
1
2
3
4
5
Tutor
$
500.00
Quantity
1
2
3
4
5
Other donation amount
$
30.00
Quantity
1
2
3
4
5
6
7
8
9
10
I would like to donate an item for the silent auction
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Total
$
0.00
Monetary value of silent auction donation in USD
Please include a detailed description of the silent auction item you are donating, as well as the value of the item. Please include a photo of the item if possible.
Silent Auction Item Image
Submit
Should be Empty: