Empoweringthepoor.org - SPONSORSHIP COMMITMENT FORM-3RD

Empoweringthepoor.org - Empowering the Poor Communities to Self-Reliance and Dignity

	Theme: Rain or Shine, we Run and Walk because every 30 seconds a child dies from malaria in Africa.
	Date: Sunday, April 22nd, 200
	Where: Downtown Fredericksburg Rappahannock Library (1201 Caroline street) Time: 7:30AM Sponsor, Run, or Walk and you automatically become a WINNER. All participants will receive free T-shirt, sun-visor, refreshments, etc. Register Now!!!! Click here to register Run/Walk Against Malaria

SPONSORSHIP COMMITMENT FORM-3RD ANNUAL MALARIA RUN WALK FREDERICKSBURG 2008

I am pleased to confirm that (organization) will participate as a:

PRESENTING SPONSOR ($10,000)

RUN WALK SPONSOR ($5,000)

BLUE RIBBON SPONSOR ($3,000)

PLATINUM SPONSOR ($2,000)

GOLD SPONSOR ($1,000)

SILVER SPONSOR ($500)

Please note that sponsorship commitments are on a first-come, first-serve basis and can only be confirmed on receipt of payment. The details of your sponsorship commitment are as follows:

Organization Name

Address:

City:

State:

Zip:

Contact Name

Telephone:

Fax

Sponsorship Commitment

Fax or mail in this form, along with the Sponsorship Commitment Form and payment to
Empowering The Poor, Inc.
Attn. Malaria Run Walk Fredericksburg 2008
35497 Coyote Trail
Locust Grove, Virginia, 22508.
Telephone: (540) 424 2705 Fax: (540) 301 0291

Include a check payable to “Empowering The Poor, Inc” or complete credit card information below.

Payment Method:

Credit /Debit Card

Cheque

Money Order

Pay Pal

Credit card Type:

Visa

MasterCard

American Express

Card Number

Exp. Date:

Name As It Appears on Card

My signature:

I accept conditions

Date:

Having signed, I confirm that I have read and am fully aware of the Sponsorship Commitment Form conditions stipulated in the Sponsorship Outline and on this form. I hereby authorize Empowering The Poor, Inc. to debit this credit card account for the total due. I also consent to Empowering The Poor debiting or crediting my credit card account with full amount of any subsequent change (s) to the items committed. I understand payment be received for Sponsorship/Exhibiting to be confirmed. Please note charges will appear on credit card as Empowering The Poor, Inc.

Empoweringthepoor.org -2006- All rights reserved. Empowering The Poor, Inc. (ETP) is a non-profit and charitable organization under section 501 (3) of the U.S. Internal Revenue Code. All contributions are tax deductible to the extent permitted by the law. Powered by CQube Data Systems