One moment please...
I wish to purchase:
*
Sponsorship - provides seat reservations & benefits; a portion of my sponsorship is tax deductible
Sponsorship - donation only; I do not wish to reserve seats and 100% of my sponsorship is tax deductible
Sponsorship Levels (a portion of my sponsorship is tax deductible)
*
$25,000
-
Presenting
$10,000
-
Bridge Builder
$5,000
-
Change Maker
$2,500
-
Servant Leader
$1,000
-
Allies
$500
-
Collaborative
Sponsorship Amount (100% deductible)
*
$25,000
-
Presenting
$10,000
-
Bridge Builder
$5,000
-
Change Maker
$2,500
-
Servant Leader
$1,000
-
Allies
$500
-
Collaborative
Contact Information
This registration is from...
Organization/Business/Foundation
Individual
Name of organization/business/foundation
*
Name of individual OR Primary contact at organization/foundation
*
First Name
Last Name
Name as it should appear for recognition
*
Phone
*
Email
*
Verify Email
*
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Event Contact
*
Please provide name, email and phone of person to be contacted regarding this event. (guest names, request for logo, etc.)
Add 3% to my total amount to help cover the payment processing fees