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					The Early Intervention Center
18300 W. 12 Mile Road
Southfield, MI 48034
248-559-5820



                      1st Annual White Gables Charity 5k Run/Walk
                                 Sponsor Donation Form

Contact Information:

 Company:

 Name:

 Address:



 City, State, Zip:

 Phone Number:

Email Address:

Donation Information:

 Cash Donation                        Donation Amount: $_________

 Merchandise or Services Donation
  (please describe) Value: $_________



    Sign Information (if not providing own)          ***email digital image of 1 color logo to
                                                     linda@thediebels.net or print plain text below***
      First Line (larger type)
      (typically company name)

      Second Line (optional)


Thank you for your donation. Your donation will be fully tax deductible, and a thank-you letter will be issued
following the event to acknowledge your generosity, and for your tax records. Your minimum donation of $50 will
ensure that You/your company will be listed on t shirts provided to each participant in the event. We will also be
providing an opportunity for you to set up information about your company at the conclusion of the event and will
make every effort to include your name in signage (you can provide a sign, or one will be provided).
                     Please complete this form and send it via mail or email to:
Early Intervention Center c/o Linda Diebel                 Phone: 843-367-5530
1st Annual White Gables Charity 5k Run/Walk                email: Linda@thediebels.net
320 Germander                                              Make Checks out to:
Summerville, SC 29483                                                      The Early Intervention Center

				
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posted:12/4/2011
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