Sponsor Form

SPONSOR AGREEMENT ONLINE FORM
REGISTRATION DEADLINE: August 1ST, 2019

CONTACT INFO (All correspondence will be sent to this person.)

* Indicates required field

Name *

First

Last

Title *

Company/Organization *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Fax *

Email *

Sponsorship Level *

IF OTHER PLEASE INDICATE AMOUNT *

PAYMENT TYPE *

BY CHECKING THIS BOX *

YES, I AGREE TO SEND PAYMENT TO: NCADD-GDA, Attn: MI Celebrate Recovery 2400 E. McNichols, Detroit, MI 48212

DATE *

Submit