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
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( X )
Educator Level
$5,000.00
$
5,000.00
Quantity
1
2
Scholar Level
$3,000.00
$
3,000.00
Quantity
1
2
Fellow
$1,000.00
$
1,000.00
Quantity
1
2
Mentor
$750.00
$
750.00
Quantity
1
2
3
4
5
Tutor
$500.00
$
500.00
Quantity
1
2
3
4
5
Other donation amount
$30.00
$
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
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Total
$0.00
$
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
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