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Presents

Trick or Trivia – October 30, 2015
A Scholarship Fundraiser for Students with Tourette Syndrome
Sponsorship & Donation Form

Sponsorship Levels

Silver Sponsor $100-$299_____       Gold $300 – $499_____           Platinum $500 and up_____
Includes 2 event tickets                    Includes 4 event tickets          Includes 6 event tickets

 

Donor Information: (Please print clearly)

Name: __________________________________________________________________

Company (if applicable):____________________________________________________

Address:_________________________________________________________________

Phone:________________________ Email:____________________________________

Raffle or Auction Donation/Item Information: (Please print clearly)*

Item/Service Donated:_____________________________________________________

Brief Description:_________________________________________________________

________________________________________________________________________

Restrictions (if applicable):__________________________________________________

Retail Value of Donation (Required): $_________________________________________

*Small donations for Goody Bags also accepted, Qty 100.

  • Please return donation(s) with this form for each item to: Dollars 4 Tic Scholars, 21801 Little Bear Lane, Boca Raton, FL 33428. We can also pick up your donation, please call Kim at 561-756-2252.
  • All donors will be recognized on our website and in an insert in the event goody bags. We will use the information you provide under “Donor Information.” If you do not wish to be listed, please indicate it on this form.
  • For questions or additional information, please contact Diane at 561-487-9526 or info@dollars4ticscholars.org.
  • Deadline for donations is Monday October 26, 2015 for coordination and printing.
  • All proceeds to Trick or Trivia benefit Dollars 4 Tic Scholars, a non-profit 501c3 organization.
  • Please note, all donations received past 10-28-15 will be listed and used for our next Foundation event.
  • Sponsors and Raffle/Auction Item donors listed at https://www.dollars4ticscholars.org/trick-or-trivia-supporters

 

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A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISON OF CONSUMER SERVICES BY CALLING TOLL-FREE WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL OR RECOMMENDATION BY THE STATE. The toll-free number of the department is 1-800-HELP-FLA (435-7352) – calling from within the state of Florida, or (850) 410-3800 – calling from outside of Florida. Registration #CH41961.

THIS PAGE IS YOUR RECEIPT. PLEASE COPY OR PREPARE TWO, ONE FOR YOURSELF AND ONE FOR DOLLARS 4 TIC SCHOLARS. THANK YOU.