EntrepreneursNOW Donation and Sponsorship Form
 

Yes! I want to be a supporter of The Entrepreneurial Course for High School Students.

___ $1,000 ___ $500 ___ $250 ___ $125 ___ $50 Other $ _____


Method of Payment
 
_____ Check/Money Order
 
_____ Credit Card
 
payable to: EntrepreneursNOWCard Number ______________________________ ________________
 
__ MasterCard ____  Visa ____ Discover Cardholder name ______________________________ ____________
 
Expiration Date: ______/_______
 
Cardholder signature ______________________________ ________

Donor Information (address must be as it appears on your credit card statement or bank account)

Name ______________________________ _______Address_______________________ _____________________

Company ______________________________ ____ _______________________ _____________________

Title ______________________________ _______ City _______________________ St______ Zip____________

Phone ______________________________ ______ Email ______________________________ ________________

Please return the completed form via Fax to: 203-841-2513, Email: DESuter@AOL.com

or mail to: EntrepreneursNOW, c/o Penny Christy, 12 Blue Grass Road, Middletown, CT 06457.

THANK YOU!