Kelly Kicking Cancer Sponsorship Form Sponsorship Level * In recognition of the efforts of the Kelly Kicking Cancer, we will make a tax deductible contribution of: $500 Sponsor $1,500 Gala Table Sponsor $2,500 Sponsor $5,000 Sponsor $10,000 Sponsor Company Name First Name Last Name Contact Name * First Name Last Name Title Email * Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Thank you! To submit payment, please send a check to:Kelly Kicking Cancer PO Box 1034 Mandeville, LA 70470-1034
