2018 Event Sponsorship Form

For questions regarding sponsorships, please contact Tracey McCollum at Tracey.McCollum@NursesOfAchievement.com. For problems or questions regarding this form or PayPal processing, please contact webmaster@NursesOfAchievement.com.

items marked with a * are required, and the form cannot be submitted if any of these values are missing!

Contact Information
We ask for your name and contact information in case we have questions about your sponsorship and to process your payment. This information is not sold or shared outside the Foundation that administers the Nurses of Achievement, and it is securely encrypted before being stored.
* first name:
* last name:
title:
company or
organization name:
* mailing address:
* city:
* state:     * ZIP:  
* phone
(nnn-nnn-nnnn):
      fax:  
* e-mail:
 
Contribution Level
* contribution option:
PLATINUM – $2,500
  • full-page program ad
  • 4 dinner tickets
  • either honor a nurse at the event or sponsor a nomination category
  • logo displayed at the event
  • verbal recognition from event host
DISTINGUISHED – $1,500
  • half-page program ad
  • 2 dinner tickets
  • honor a nurse at the event
  • logo displayed at the event
  • verbal recognition from event host
CONTRIBUTING – $1,000
  • quarter-page program ad
  • sponsor a nomination category
  • logo displayed at the event
  • verbal recognition from event host
SUPPORTING – $500
  • recognition in event program
  • verbal recognition from event host
OTHER AMOUNT
 
Special Instructions
* attribution for donation:
myself
my company/organization
"in memory of"
"in recognition of"
anonymous donation
 
Payment
* payment method:
online payment       send check
 
Process Order
at least one required field is empty or has invalid contents