G.W. Dinner Sponsor Sign-Up Sheet

$2,500 Platinum Sponsor

$1250 Gold Sponsor $750 Silver Sponsor

$500 Bronze Sponsor $300 Table Sponsor

Company Information:

Company Name: _______________________________________________________________

Billing Address: _______________________________________________________________

Street: City: State: Zip:

Please print how you would like the sponsor name to appear for recognition if different than company name

above: _________________________________________________________________________________

Sponsor Representative Information:

Name: ________________________________ Title: _________________________________

Office Phone: __________________________ Cell Phone: ____________________________

E-Mail Address: ______________________________________________________________

Address: ____________________________________________________________________

(if different than billing address) Street: City: State: Zip:

Signature: ___________________________________________ Date:___________________

Please include check payable to: Masonic Lodge #89

Include this sheet and mail to:

Masonic Lodge #89 AF&AM, 703 Robinson Dr. Marion, IL. 62959

For more information or questions please contact:

Jason Shadowen 618.925.0210

Or

Jim Webb 618.996.2981

SPONSORSHIP LEVELS 4th Annual George Washington Dinner

Time & Location