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.