CHEERS OHIO
presented by Altrusa International of Columbus
Tax ID: 14-1939643
Please complete this form to donate auction items, become a sponsor and/or buy ad space. Cheers Ohio will take place on Saturday, May 21, 2016
.
Contact Information
Business/Contributor
*
Contact Name/Title
*
Address
*
City
*
State
*
Please Select
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
*
Phone (primary)
*
Fax
E-mail
*
Donated Item(s) for Auction
Please indicate what item(s) you are donating for auction:
estimated value:
Item(s) :
Will be mailed (see below for mailing address)
Needs to be picked up
Note
: please allow any certificates/gift cards to be valid for one year, exp. date May 21, 2017
Sponsorship Rates & Rewards
Sponsorship Levels
Please indicate the appropriate sponsorship level:
$1,000 Platinum
$750 Gold
$500 Silver
$250 Bronze
$100 General
Program Ad Sales
Please indicate the appropriate ad space:
Full Page (8"x6.5") $150 each
Half Page (4"x3.25") $100 each
Quarter Page (2"x1.625") $75 each
Eighth of Page (1"x.8125") $50 each
If you would like to attach artwork/design for your ad please do so here:
Select File
Cancel
of
OR
You are unable to include artwork/design for your ad at this time (please email your design to altrusa.cheersohio@gmail.com no later than May 12, 2016 for inclusion.)
Payment Method (if applicable)
Please check one of the following:
Visa
MC
Discover
AMEX
Mailing check
Mailing cash
Name on credit card
Amount $
Number
Expiration
-
Month
-
Day
Year
Date
Security Code
Signature
Check amount $
Cash amount $
Submission Method
To finish hit
SUBMIT
below or print & mail to:
Attn: Joy D. Reyes
Altrusa Cheers Ohio
92 Jefferson Avenue
Columbus, Ohio 43215
You may direct any further questions to:
altrusa.cheersohio@gmail.com
614.321.2422.
Submit
Should be Empty: