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2021 BMHA Dr. Maxie T. Collier Awards Sponsorship Commitment Form
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Email
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Contact Information
Name
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Address
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Phone Number
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Please print name of individual(s) or business on the line below as you would like for it to appear for recognition purpose.
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Social Media Handles
Website
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LinkedIn
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Twitter
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Facebook
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Instagram
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YouTube
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Sponsorship
I/We would like to be a sponsor for DR. MAXIE T. COLLIER VIP RECEPTION & AWARD CEREMONY at the following level:
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Phoenix Sponsor - $20,000
Heritage Sponsor - $10,000
Legacy Sponsor - $5,000
BMHA Advocate Sponsor - $2,500
BMHA Community Sponsor - $1,000
BMHA Supporter - $500
*DISCLAIMER: By typing your name below, you are signing this form electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application. Signature of Legal Representative
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Please submit a high logo
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Send as an attachment to
r.feenster@blackmentalhealth.com
https://bit.ly/mtc2021pic
To submit your sponsorship payment click the link:
https://dsnp.co/WKkuHP
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If your sponsorship includes dinner(s), click the link to submit your order(s):
https://forms.gle/4iALhVeiTDnAwXE67
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A copy of your responses will be emailed to the address you provided.
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