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FormDive Into Life Donation Form
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Thank You For Your Support!

Thank You For Your Support!

Thanks to you, we are on our way to holding a successful fundraiser to benefit the veteran and disabled community.  We are thankful for your sponsorship, and together we can positively affect the lives of many.  Please take a few moments to work out the details of your pledge.
How Can You Help Out?

How Can You Help Out?


Specify Sponsorship Level, Item(s), and/or Monetary Donation Amount:

Specify Sponsorship Level, Item(s), and/or Monetary Donation Amount:

Sponsorship Levels available: 
$10,000: Poseidon Event Sponsor (only one accepted)
$6,000: Hurricane Sponsor
$4,000: Mermaid Sponsor
$2,000: Turtle Sponsor

Item Donation: 
Can you offer a product (enter description and retail value)?
Are you offering a gift certificate for services (description, retail value)?

Monetary Donation:
Enter Value


Contact Information

Contact Information

First Name*

Last Name*

Company

Address*


City*

State*
Postal Code*

Country*
Email*

Day Phone*

Evening Phone

Recognition of Sponsorship

Recognition of Sponsorship

Please note exactly how you would like your company or organization listed when supported events are promoted.  
If you would like us to use your company logo, or if you purchased advertisement and would like a specific advertisement in these instances, please send a .jpeg or .gif file with the logo to serena@adaptivescubaprograms.org




How Would You Like to Transfer the Pledged Donation?

How Would You Like to Transfer the Pledged Donation?

Verifier

Verifier

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