Business and Professional Partner Sign-Up

    ________Yes, I (we) wish to become a Business/Professional Partner by means of a:
                                              
              ____________ lump sum; please fill in amount ($500 minimum for a period of one year with a flexible
     
              ____________ monthly donation—can be done by automatic transfer; please fill in amount 
                                                                            ($42 monthly minimum for one year to be a Partner)
     
    __________I am (we are) unable to pledge a minimum amount of $500, but wish to support Give a Little with a                           donation of:             ____________ (please fill in any amount)
     
    Name: ________________________________________Date:______________________________________
    Business/Professional name: ______________________________________________________________________________
    Mailing address: _________________________________________________________________________________________
    Website: ____________________________________________         Phone:_________________________________________
    Email address(es) for quarterly newsletter and occasional updates on news or special events (please make a note here if you prefer to receive all such correspondence by regular mail, or if you prefer not to receive any mailings):________________________________________________________________________________________________