Sponsor Form

___Yes, I want to be a corporate sponsor.

My annual sponsorship level is:

___ Diamond ($3000.00)

___ Platinum  ($2000.00)

___ Gold     ($1000.00)

____ My check payable to Positively Pink Packages is enclosed

____ Please charge my credit card (VISA, MasterCard, Discover)

___________________________________________________________________
Credit Card Number                     Exp. Date 

___________________________________________________________________
Name on Card

___________________________________________________________________
Billing Address

___________________________________________________________________
City  State  Zip

Name of Organization: _____________________________________

Address: ________________________________________________

_______________________________________________________

Contact Person:___________________________________________

Phone #  _______________Website: _________________________

Please fax your form and tax deductible donation to (315) 637-5031 or
Mail to Positively Pink Packages PO Box 208 Fayetteville NY 13066