Hampton Roads Section

Pledge Form

TechSurge Sponsorship Pledge Form



Yes, ___________________________________________________ is pleased to commit to be a sponsor of the MTS – Hampton Roads Section TechSurge. We have indicated below which level of sponsorship for which we will participate.



_______          Gold Level ($1,000)


_______          Silver Level ($500)


_______          Bronze Level ($250)




Contact Name: _________________________________________________________________


Address: ______________________________________________________________________



Phone Number:___________________________  Fax Number: __________________________


Email Address: _________________________________________________________________



Payment Options:

____    Bill me


____    Check made payable to MTS – Hampton Roads is included


____    Please charge my credit card in the amount of $______.

Type of card:___________________________________________________________

Name on card: __________________________________________________________

Card number: ___________________________________________________________

Expiration date: ______________________________ CVC number: _______________

Signature of card holder: __________________________________________________



Please contact Joy Eyrolles at (757) 664-1037 or joy.eyrolles@norfolk.gov

 with any questions regarding sponsorship of the conference.

Mail this form back to Joy Eyrolles, Nauticus, 1 Waterside Drive, Norfolk, VA23510
or fax it to (757) 664-1018.