Become a Sponsor! -

What type of sponsorship would you like to offer? *

I Want to Sponsor the Women Who Care Bootcamps
I Want to Sponsor a Caregiver for the next Annual Day of Respite (Sept 2024)
I Want to Be a General Programs Sponsor for 2024
I Want to be an Event Sponsor (please complete “Event Sponsor Info” section below)
Other (please list below)

Other (please list)

Donation Amount (USD) *

Donation Amount (USD)

Selected Value: 500

Sponsor Name *

First

Last

Sponsor Email *

Sponsor Phone *

Company Name

Company Website

Main Company Number

Company Address (Street, City, State, Zip)

Sponsor Level *

Complete this section if you have chosen to be an Event Sponsor. Each event requires a separate application.

Please Choose an Event

Please list the names of each representative that will be present for this event

Please provide a description and quantity of all items you plan to give away and/or the topic/demonstration you plan to present:

Attestations

As a Sponsor, I understand that all donations are non-refundable as they are used to support the programs provided by Janice Williams, RN. *

I understand and agree

As an Event Sponsor, I understand that I am responsible for providing my own equipment – ie: table cloths, decorations, giveaways (One 6 foot table and two chairs will be supplied for each company). *

I understand and agree
I am not an event sponsor this time around

As an Event Sponsor, I understand that I am responsible for ensuring that at least one representative will remain on-site throughout the duration of the event. *

I understand and agree
I am not an event sponsor this time around

As an Event Sponsor, I understand that I am responsible for leaving the area designated for my organization, in the same condition as it was presented. *

I understand and agree
I am not an event sponsor this time around

Completion of this application, is not a guarantee of acceptance as a sponsor or event vendor. Your submission will be reviewed within 10 days. *

I understand and agree

Electronic Signature *

By typing your name above and attesting to the statements above, you, as a representative of your company, verify that the information contained in this Sponsor Registration form is true to the best of your belief. Janice Williams, RN or their affiliates will not be held liable for lost, stolen or damaged goods, or any injury incurred during the above selected event.

Date *