Annual Awards Banquet
October 19, 2011 
Sponsorship Request Form
Please submit by Friday September 23, 2011

Name of Business:__________________________________________

Address:_________________________________________________

Contact:__________________________________________________

Phone:__________________Email:_____________________________

I would like to sponsor the Environmental Awards Banquet.

        []  Event Sponsor $2,500 or $5,000 Exclusive
            (be sure to include logo and 5"x8" ad)
      
        []  Entertainment Sponsor $1,000
                (be sure to include logo and 5"x4" ad)

        []  Bar Service Sponsor $500
                (be sure to include logo)

        []  Dessert Sponsor $300 

        []  Award Recipient Sponsor $100

If you have selected to be an Event or Entertainment sponsor, please be sure to include your appropriate sized advertisement for our Program Book.  (preferred format is jpeg)

Enclosed is my check for $____________ 
(payable to Perkiomen Watershed Conservancy or PWC)

Please bill my:         VISA           Mastercard            Discover              American Express

Acct # _________________________________________________________

Signature _______________________________________________________

Please print name as it appears on card ______________________________________________________

Completed form can be sent to:

Perkiomen Watershed Conservancy
1 Skippack Pike
Schwenksville, PA 19473
ATTN: Events Committee