Sponsor Commitment Form
Print, complete and mail
To become a sponsor, click the Print or Download button to complete the form below. Then, submit the completed commitment form along with your sponsorship payment to the address provided. You may also complete the commitment form online.
Sponsor Commitment Form
Return commitment form by September 28th
Company Name:
Primary Contact:
Phone:
Email:
Sponsorship Level:
Payment Method:
Signature:
Date:
Sponsorship Levels
- Platinum $5000
- Gold $3000
- Silver $2000
- Bronze $1000
- Entertainment Sponsor $500
- Wine Sponsor $500
- Swag Sponsor $500
- Dessert Sponsor $500
Remit Sponsorship To
United Way of the Pine Belt Region
P.O. Box 2026
Laurel, MS 39441
For Additional Information
Betsy Ivey,
Executive Director
Director@uwpbr.org
601.428.8459