Application to Become an Ambassasor Club Sponsor

Business/Organization Name *

Please tell us the name of the business or organization which will be sponsoring the Ambassador Club.

Please provide the name and title of the contact person assocated with this sponsorship.

Title

First Name *

Last Name *

Suffix

Telephone Number *

Please provide us with a telephone number for the contact person.

Email Address *

Please provide us with an email address for the contact person.

Gift Distribution Preference *

I prefer to donate all four items at once in January. I prefer to donate items quarterly in April, July, October, and January.