Sponsorship Form

Please only use this form if you are paying for your sponsorship via check or an in-kind donation. If you wish to use a credit card, please click here.

Please send checks to:

Keene Pride
25 Roxbury St.
Suite 114
Keene, NH 03431

Organization Name

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

EIN/Tax ID

Website

http://

Authorized Signer Name

First Name

Last Name

Position

Select Sponsorship Level

Payment Method

Check Number

In-Kind Donation Description

If you are paying for your sponsorship using an in-kind donation, please list the goods/services donated and their fair market value.

In Kind Donation Value

Any notes or comments?