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Sculptors Dominion International, Inc., 501c3, Federal ID #20-4378229
Copy/Mail This Form To: The Sculptors Gala, 11354 Vance Jackson Rd., San Antonio, Texas 78230
or gilbertebarrera@gmail.com * 210.696.9813 * 210.413.0498
SPONSOR / CONTRIBUTOR FORM
Name __________________________________________________________________________
Position __________________________________________________________________________
Company __________________________________________________________________________
Mail Address __________________________________________________________________________
City State Zip __________________________________________________________________________
Phone __________________________________________________________________________
Email __________________________________________________________________________
Fax __________________________________________________________________________
Signature/ Date __________________________________________________________________________
ENCLOSED IS MY DONATION OR PLEDGE
_____ I am sending a check now and copy of this form
_____ I am pledging now to send a check for $_______, please call me in January
_____ I am unable to attend but will make a straight contribution
DESCRIPTION OF SPONSORSHIP OR CONTRIBUTION
QTY ITEM DONATION
______ Table(s) at $ ________
______ Chair(s) at $ ________
______ Program ad at $ ________
______ Straight Contribution at $ ________
INCLUDED ARE THE NAMES OF ME AND GUESTS I WILL BRING.
1. 5.
2. 6.
3. 7.
4. 8.
Further Description or Notes....
Make checks payable to
‘Sculptors Dominion International, Inc. 501c3’ 11354 Vance Jackson Rd. San Antonio, Texas 78230
*210.696-9813