Hands on Hope Sponsorship Form
Please select your sponsorship level.
Legacy of Hope Partner - $30,000
Hope Builder Partner - $25,000
Medical Narrative Partner - $15,000
Champion of Hope Partner - $10,000
Expansion Sponsor - $5,000
In-Kind Sponsor
In-Kind Sponsorship
Description of goods/services
Estimated value
Company Information
Company Name
Website
Street
Address Line 2
City
State / Province
ZIP / Postal Code
Country
Primary Contact Information
First
Last
Title / Role
Email
Phone
Branding / Marketing Assets
How should your company be listed publicly?
Company Logo upload
Please attach the logo you would like us to use for promotion.
(Optional) Brand guidelines / preferred logo version
Sponsorship & Payment Details
Payment Preference
Check (preferred)
ACH / Bank transfer
Credit Card
We will send an invoice after form submission. Checks and ACH are preferred. Credit card payment options will be included upon request.
Billing Contact (if different)
Email
Additional Comments/Questions
Agreement
By checking this box, I hereby acknowledge and agree to fulfill this sponsorship commitment.