"Ride for the Relay"
Sponsor Application 2013
Check all appropriate boxes below:
Rider ( ) Passenger ( ) Auto ( ) Non-riding Sponsor ( )
Starting Point:_______________ Ending Point:_______________
Name:_________________________________________________
Corporation:___________________________________________
Address:_______________________________________________
City/State/Zip Code:_____________________________________
Telephone: ( ) ______ - _______________
eMail address:_______________________@___________________
Corporate Sponsor: ( ) $660
Pin Sponsor: ( ) $300
Gold Sponsor: ( ) $66 + $66 = $132
Silver Sponsor: ( ) $66
Rider Sponsor: ( ) $66
Bronze Sponsor: ( ) $33
Helper Sponsor:___ Prayer Sponsor:___
Special Donation $___________
Send all Sponsorships to:
"Ride for the Relay"
Rodger L. Fox
63 East Central Park Plaza
Jacksonville, Illinois 62650
Make all Checks payable to: "Ride for the Relay"
