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Company:----------------------------------------- Contact Person:---------------------------------------- Address:---------------------------------------------- City:---------------------------------- State:---------------- Zip:----------------- Telephone: --------------------------------- Fax:------------------------------------------ e-mail ---------------------------------------- Web Site: -------------------------------------- Your sponsorship program: Yes, sign me on for one year sponsorship, start at $3000 individual and $5000 corporte level No, but here is a contribution of $ ……… (Keep up the good work) Your Promotion Program : Your Signature __________________ Date ________
Please send your sponsorship form with your check today to: Belahdan |