Southern Social

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Southern Social Private Sponsorship

Print your name as you wish it to appear on materials*
Contact first name/title*
Contact last name*
Email address*
Billing address*
City*
State*
Zip code* -
Telephone*() - ext.
Fax() - ext.

Sponsorship
Sponsorship levels available:
Host - $500
Supporter - $350
Sponsorship level*
Additional Southern Social tickets
may be added for $50
per person with
a paid sponsorship package:
(This ticket does not
include a T-shirt.)
Additional Donation Amount
Total to be billed:

Payment Information

*
*
Credit Card Expiration Date*
*
(Located on the back of the card)