Sponsorship Application

Please complete this form if you are interested in sponsoring our chapter.

Name * *

Company Name * *

Email * *

Phone

Package * 6 month Basic Package (member) $100 6 month Basic Package (non-member) $200 12 month Basic Package (member) $175 12 month Basic Package (non-member) $275

Would you like to add the Ultimate Performance? * Yes, I'd like to present at an upcoming meeting No, I am only interested in the Basic Package

Presentation month requested (1st & 2nd choice)

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Sponsorship Application

Chapter #0699

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