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Individual Sponsor Form: Enrich. Empower. Engage. Gala
March 15, 2024 at 6:00 pm
at Hubbard's Off Main * 16 Choccolocco Street Oxford, AL
If you have any questions email andrea@safehavencounseling.org
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* Indicates required question
Name (as you wish it to appear on promotional materials) Please also note here if you do not want your name listed.
*
Your answer
Contact Name (if different from above)
Your answer
Phone Number
*
Your answer
Email
*
Your answer
Individual Sponsorship Levels
Type of Sponsorship
*
Individual Silver ($50)
Individual Gold ($75)
Individual Platinum ($150)
I will submit payment in the following form:
*
Paypal:
paypal.me/SafeHavenCounseling
A check or money order mailed to P.O. Box 7842 Oxford, AL 36203
Other:
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