MÉLANGE GALA 2015 SPONSORSHIP REPLY FORM Yes, I would like to sponsor the 11th annual Mélange Gala on Saturday, November 7, 2015! Platinum | $25,000 Silver | $5,000 Patron | $1,000 Gold | $10,000 Bronze | $2,500 Supporter | $500 Please make checks payable to Milford Regional Healthcare Foundation and mail to 14 Prospect Street, Milford, MA 01757. All sponsorships are tax-deductible to the fullest extent of the law. Contact Name: _______________________________________________ Title: _________________________________ Name or Company (as you would like it appear on event materials): ____________________________________________ __________________________________________________________________________________________________ Street: ______________________________________________________________________________________________ City: ___________________________________________ State: _____________________Zip: _____________________ Phone: _________________________________________ Cell: _______________________________________________ Email: ______________________________________________________________________________________________ Payment enclosed Please send an invoice Milford Regional Healthcare Foundation 14 Prospect Street, Milford, MA 01757 foundation.milfordregional.org/Melange Contact Kelly See at 508-422-2034 [email protected] for more information. Hopedale Community House, Inc. To have your name removed from our distribution list for future fund raising materials designed to support Milford Regional, please contact us at this same address.
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