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The Beauty of Neurology Mixer- Sponsorship Request Form

Thank you for choosing to sponsor our event! All proceeds and sponsorships directly support our Family Support Program, as outlined in the sponsorship deck. For full details about sponsorship opportunities, please refer to the deck or reach out to Kim Hindery at khindery@childneurologyfoundation.org. After this form is submitted, you will receive instructions via email within 2 business days regarding payment.
1.Event sponsor name (business, organization, or individual):(Required.)
2.Name of contact person and title:(Required.)
3.Contact person's email address:(Required.)
4.Contact person's phone number:(Required.)
5.Please provide any information about your business that you would want included (if applicable):
6.I would like to sponsor at the following level:(Required.)
7.All sponsorships are greatly appreciated. Please sign your name below for agreement to being a Beauty of Neurology Mixer sponsor. Thank you so much for your support. *By signing your name below you are agreeing that your electronic signature is the legal equivalent as your manual signature on this sponsorship form. (Required.)