2019 Texas Statewide School Outreach Collaborative Effort (online sponsorship form) Because EVERY school in Texas should be aware of pipeline safety! Are you ready to accelerate school pipeline safety in Texas? Please fill out this form to pledge your $5,000 support for the 2018-2019 school year/program cycle and help make Texas Schools a safer place when it comes to pipelines. Contact Information Question Title * 1. Contact Information Name and Title Company Mailing Address City/Town State/Province ZIP/Postal Code Email Address Phone Number Billing Information (please skip if same as above) Question Title * 2. Billing Information (please skip if same as above) Name and Title Company Address City/Town State/Province ZIP/Postal Code Purchase Order Number (optional) Email Address Phone Number Please Select All Program Years You Wish to Sponsor Question Title * 3. Please Select All Program Years You Wish to Sponsor 2nd Program Year (Sept 1, 2017 - Aug 31, 2018) $5,000 (Get last cycles results) 3rd Program Year (Sept 1, 2018 - Aug 31, 2019) $5,000 Please tell us when you would like invoiced: Question Title * 4. Please tell us when you would like invoiced: Now Later (After January 2019) Other (please specify) For your convenience you may select who you prefer to be invoiced by for this program: Question Title * 5. For your convenience you may select who you prefer to be invoiced by for this program: Danielle Dawn Smalley Foundation Paradigm How, where, or from whom did you hear about this program? Question Title * 6. How, where, or from whom did you hear about this program? On behalf of Team Smalley and Texas schools everywhere, thank you for helping us make this program possible!You will receive an email soon explaining what to expect next! Click to Submit!