Sponsor Form

Print to mail

TO:     Keith-Ann Wagner Hope Relay Auction & Dinner

From ___________________________________________

Address _________________________________________

City/State ______________________________Zip ______

Charitable contribution of $ _____________

Premier Sponsor $3500

Cost of one month of therapy

Platinum Sponsor   $1000

Cost of one week of therapy

Gold Sponsor         $300

Cost of one day of therapy

Silver Sponsor   $100

Cost of one hour of therapy

Mail to:Keith-Ann Wagner Hope Relay

P. O. Box 173582

Arlington, TX  76003

Thank you in advance for your help in making the Sixth Annual Keith-Ann Wagner Hope Relay Auction and Dinner a success.

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