2020 – 2021 NATIONAL SPONSORSHIP AGREEMENT

2020 – 2021 NATIONAL SPONSORSHIP AGREEMENT

Please complete the following and return it with your check or credit card information. Thank you for your support!

Organization Name: _____________________________________________________________  

Contact First & Last Name: ________________________________________________________

Contact’s Title:__________________________________________________________________  

Surface Mailing Address: _________________________________________________________ City:__________________________________ State: ________ Zip Code:__________________   Email Address:_________________________________________________________________ Telephone : (_____)_______________________ Fax : ( ____)________________________  

Please indicate your sponsorship level: 

[ ] Premier $25,000+     [ ] Platinum $5,000+

[ ] Crown $10,000+       [ ] Gold  $2,500+

[ ] Silver $1,000+

Method of payment:    [ ] Check (payable to HazingPrevention.Org) [ ] Credit card (please specify)

              [ ] Visa   [ ] MasterCard   [ ] Discover   [ ] American Express

Name on account:  

__________________________________________________________________________________

Account number:                                                                  

__________________________________________________________________________________

Expiration:   CVC Code:                                                   

__________________________________________________________________________________

Please mail form and payment to:      

HazingPrevention.Org

136 Everett Road 

Albany, NY 12205

If you have questions email info@hazingprevention.org