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Sponsorship Form
Agency Information
Agency
*
Agency Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Agency Website
Agency Phone
Agency Description
Contact Information
Contact Person
*
First Name
Last Name
Contact Phone
Contact Email
*
Verify Email
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Name and Title for Name Badge
Sponsorship Opportunities
Sponsorship Options:
Check all that apply
$5,000 - Agency Champion
$2,500 - Mental Health Educator
$1,000 - Annual Conference Supporter
$500 - Walk Advocate (apply by 4/30/20)
$250 - NAMI Maine Friend
$1,000 - CIT Awardee Supporter (apply by 4/30/20)
$500 - CIT Table Sponsor (apply by 4/30/20)
Advertising Options
Check all that apply
$500 - Full Page Exterior Back Cover
$400 - Full Page Interior Back Cover
$300 - Full Page Interior Program Page
$250 - Interior Half Page
$200 - Interior Quarter Page
Amount
*
$
Add 3% to my total amount to help cover the payment processing fees