2023 Mitchell & Brown Retravision Gala Dinner Sponsorship Registration

Name of group or organisation sponsoring

Contact Name(Required)

Phone(Required)

Email(Required)

Website Address

Street Address

Please upload a copy of your logo so we can promote your organisation in recognition of your sponsorship

Drop files here or

Accepted file types: jpg, pdf, png, Max. file size: 10 MB, Max. files: 2.

Logo files must be less than 10mb in size.

Which sponsorship category does this fall under?(Required)

Description of donated item (please list details of item or cash donation)

Value of donated item or amount donated

How many tickets to the Gala Dinner would you like to purchase?(Required)

Ticket costs are not included as part of the sponsorship packages and will be invoiced at $270 per ticket. There are limited tickets per sponsor. If you are unsure of how many tickets you are entitled to, please refer to the sponsorship packages.

Invoicing
You will receive an invoice for cash donations PLUS any additional Gala Dinner ticket purchases.

Thankyou Certificate(Required)

We are doing our best to go green where possible, please tick the box if you require a Thank You Certificate and please provide a postal address.

Yes, Please send me a certificate

No, I don't require a certificate

Your Postal Address(Required)

Terms & Conditions(Required)

Please read our Terms & Conditions

I agree and acknowledge than on completion of this form, Midwest Charity Begins at Home Inc will invoice our organisation for the full investment amount of sponsorship and tickets.

Yes

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