JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Room Sponsorship Form
Thank you for your interest in sponsoring a room at our program home!
In order to secure your sponsorship, please complete the following information and submit this form upon completion:
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
I would like to become the sponsor of the following room:
(one year sponsorship)
*
Patience Bedroom $6,000
Fireplace Room $8,000
Assistant Program Directors Office $4,000
Agape Overnight Staff Bedroom $6,000
Learning Center $6,000
Transitional Living Resident Kitchen $5,000
Transitional Living Dining Room $3,000
Transitional Living: Living Room $3,000
Transitional Living Case Manager Program Office $3,000
Back Staircase with Fire Escape $500
Metal Barn $2,000
Front Porch Sitting Area $3,000
Required
I would like the following Bible verse to appear on my sponsorship plaque.
Note: Our default translation is New Living Translation. If you prefer another translation, please designate it. Example: Psalm 37:3-5 ESV
Your answer
I would like the following name(s) to appear on my sponsorship plaque. Please type exactly how you would like your title/family/group name to be displayed. If you choose to remain anonymous, please type anonymous.
Your answer
(Optional) I would like to sponsor this room in honor/memory of someone:
In Honor of
In Memory of
If applicable, please provide the address of your honoree(s) so that we may acknowledge their sponsorship gift:
Your answer
Date:
*
MM
/
DD
/
YYYY
Name of Sponsor or Sponsoring Organization/Group *
*
Your answer
Address
*
Your answer
Phone
*
Your answer
Payment (please select one) *
*
I will mail a check to Refuge for Women *This is the preferred method to avoid 3% credit card transaction amount** (See below for address)
Please contact me about donating with company stock
Online with credit or debit card (you are asked to cover the approx 3% transaction fee)
Please mail sponsorship checks to:
Refuge for Women Texas Gulf Coast
810 Dixie Dr. N. Suite J #159
Clute, TX 77531
To make your sponsorship gift online follow this link:
https://refugeforwomen.org/give/texasgulfcoast/
PLEASE BE SURE TO SUBMIT THIS FORM WHEN COMPLETED
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Refuge For Women.
Report Abuse
Forms
