Glitz & Grits Sponsor Form 2009-10

(PLEASE PRINT)

 Name_____________________________________________________________________

 Address___________________________________________________________________

 City, State, Zip_____________________________________________________________

 Phone_____________________________________________________________________

 Contact Name______________________________________________________________

 Name as it should appear in program and event publicity:

 _________________________________________________________________________

Platinum Sponsor, $5,000    _____                       Gold Sponsor, $2,500  _____

Silver Sponsor, $1,000        _____                       Bronze Sponsor, $500  _____

Supporter, $250                 _____                       Individual Ticket, $50    ______

I am unable to attend, but would like to make a donation of $______________

Checks should be made payable to Friends of the Louisiana State Exhibit Museum, Inc.

Please print this form and send to:

Friends of the Louisiana State Exhibit Museum, Inc.

Post Office Box 38356

Shreveport, LA  71133

 
The Friends of the Louisiana State Exhibit Museum is a not-for-profit 501(c)(3) organization. Your contribution is tax deductible to the amount allowed by law.
 

For more information, call 318-632-2020 or email info@friendsoflsem.org.