A Repeating Donation, As Follows: [ ] Monthly [ ] Quarterly [ ] Yearly, amounting to a Total of $ ______________ A One-Time Donation, As Follows: [ ] $12,500 Diamond [ ] $3,000 Partner in Love [ ] $10,000 Premier Platinum [ ] $2,000 Partner in Hope [ ] $7,500 Platinum [ ] $1,000 Partner in Faith [ ] $5,000 Gold [ ] $_____ Partner in Support A Lunch / Dinner Event Sponsorship, As Follows: [ ] $2,500 Luncheon Sponsor [ ] $800 Dinner Table Sponsor [ ] $1,500 Speaker Sponsor [ ] $600 Luncheon Table Sponsor MATCHING CONTRIBUTIONS Does your employer match donations? YES / NO Please enclose a signed Matching Donation Form from your employer if applicable