Champions Sponsor Champions Sponsor Form Business Name*(Exactly as you would like it to appear)Business Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Person* Dr.MissMr.Mrs.Ms.Prof.Rev. Prefix First Last Phone*Contact Email* Website AddressIs this a sponsorship or digital ad?*SponsorshipDigital AdWould you like to be pay now or be invoiced?*Pay NowInvoice UsSponsorship Level*Presenting - $10,000Platinum - $7,500Gold - $5,000Silver - $2,500Bronze - $1,000Other DonationSponsorship Level to Invoice*Presenting - $10,000Platinum - $7,500Gold - $5,000Silver - $2,500Bronze - $1,000Other DonationDigital Ad Size*Full Screen - $500Half Screen - $350Quarter Screen - $250Digital Ad Size to Invoice*Full Screen - $500Half Screen - $350Quarter Screen - $250Other Donation Amount* Other Donation Amount*Would you like to upload digital ad now?*If no, please email ad to kguinan@thecpca.org no later than April 13th.NoYesFile*Max. file size: 32 MB.Would you like to purchase any additional tickets?*NoYesTickets Quantity Price: $150.00 Quantity Quantity1 - $1502 - $3003 - $4504 - $6005 - $7506 - $9007 - $1,0508 - $1,2009 - $1,35010 - $1,500Total $0.00 CAPTCHA