Lakeshore Long Run and Palmer pump 5k Sponsor commitment Form Name(Required) First Last Title Organization Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone(Required)Email(Required) Follow-up Contact PhoneFor all printed materials please list how the recognition of the sponsorship gift should appear:Sponsorship Level(Required) Platinum sponsor Gold sponsor Silver sponsor Bronze sponsor In-Kind donation In-Kind donation Signature(Required)CAPTCHATotal Payment MethodPayPal CheckoutCredit Card DiscoverMasterCardVisaSupported Credit Cards: Discover, MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name
