Sponsors

Any amount of sponsorship is welcomed and appreciated. You may print or download the form below, or call

The ALS Association Florida Chapter at 1-888-257-1717 if you wish to contribute by phone.

You may also mail your sponsorship check made out to The ALS Association ~ Florida Chapter, C/O

The ALS Association, Florida Chapter
3242 Parkside Center Circle
Tampa, Florida 33619  

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 click the link below to get it.  It's free!                                             

All sponsors will be listed in our program.

For an auction donation, please mail the item to:

Susan Johnson

18331 Verona Lago Dr.

Miromar Lakes, FL 33913

Name______________________________________________________________

Address_____________________________________________________________

           _____________________________________________________________

Phone______________________________________________________________

E-mail______________________________________________________________

Company name_____________________________________________________

Company address___________________________________________________

                           ____________________________________________________

Description of item for silent auction__________________________________

______________________________________________________________________

Approximate value of auction item____________________________________

Donation amount (no advertisement in the program) __________________

Sponsor amount

$100-$499 for business card ad_______________________

$500-$999 for a half page ad__________________________

$1,000 and above for a full page ad____________________

Type of credit card_____________________________________

Credit card number____________________________________

Expiration date_______/_______

Name on credit card____________________________________

Please E-mail your ad copy to ssjsox@yahoo.com  by February 25, 2007