SPONSORSHIP FORM

Supporter’s Name___________________________________  Telephone___________________
 
Address___________________________________  e-mail______________________
 
 ___________________________________  Zip__________-______
 
Web Site___________________________________

Please check:
_____ $1000 Sponsor
_____ $250 - $999Benefactor
_____ $100 - $249Patron
_____ $50 - $99Donor
_____ $25 - $49Friend

Below, type your name as you wish it to appear among ImS Supporters.

 
________________________________________________________________________
 
 
Amount ________________Date ________________________
 
 
Please return to: Immaculata Symphony
Immaculata University
Immaculata, PA 19345-0703