2015 “High Hopes” Golf Tournament Monday, June 29, 2015 SPONSORSHIP COMMITMENT FORM (please print clearly) Name ________________________________________________________________________________ Company Name ________________________________________________________________________ (as used for promotional purposes) Address ______________________________________________________________________________ City ________________________________________ State ____________ Zip Code ________________ Email Address _________________________________________________________________________ Yes, sign my company/organization up for the following sponsorship level. No, my company/organization is unable to sponsor the event; however, enclosed is a donation in the amount of $________. Enclosed/attached is a check payable to Hope Hall for the full amount. Please charge $_________ to my: (please circle) MC VISA Discover American Express Name as it appears on the card ____________________________________________________________________ Card number ____________________________________________ Exp. Date _______ Billing Zip Code _______________ CVV Code ___ ___ ___ Please check box Sponsor Level Amount Eagle Sponsor $7,500 Birdie Please check box Sponsor Level Amount $3,000 Dinner $2,500 Par $1,350 Beverage $1,500 Bogey $650 Cart $2,000 Corporate $350 Lunch $1,000 Single-Hole $200 Hole-in-One $1,000 Foursome $600 Scholarship $750 Golf for One $150 Tee Prize $500 Dinner Only $35 Golf Ball $250 Other ___________ $ Total $ $ Total $ Description of In-Kind Contribution (gift certificates, product, services, etc.)____________ ____________________________________________________________________ ____________________________________________________________________ Value of In-Kind Contribution: $_________________________ Please mail completed form to: Christina Westmiller, Development Associate Hope Hall, 1612 Buffalo Road, Rochester, NY 14624. THANK YOU!