Sponsor Information
Sponsor Level (Please Check)
Diamond ($15,000) Emerald ($10,000) Sapphire ($5,000) Ruby ($2,500) Pearl ($1,000)
*Sponsor Name
*Name As It Should Appear In All Publications (Eg: Company or Individual name Presented by _______________)
*Address
*City	*State	*Zip
	- Select - Georgia Non-US Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
*Email Address
*Telephone		Cell Phone
Fax		Text? (Select One)
		Yes No
Best Contact(Select One) - Select - Telephone Cell Phone Fax
Mail Invitation/Tickets To (Check if same as address above.)
*Address
*City	*State	*Zip
	- Select - Georgia Non-US Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
I WILL I WILL NOT	USE THE HOTEL ROOM PROVIDED (All levels except PEARL)
PLEASE BILL ME	All checks MUST be received NO LATER than March 1, 2011) Make checks payable to:
	WESLEYAN PARENTS CLUB c/o Detra Abernathy 5152 Brooke Farm Drive Dunwoody, GA 30338 (404) 310-0864 / text messages accepted Email: detra_ab@bellsouth.net (detra_ab)
I WILL USE A CREDIT CARD. PLEASE CALL ME FOR THIS INFORMATION.
Please submit this form prior to January 18, 2011!
Many, many thanks for your generous support!