Sponsor Registration Form

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1
Company Name
Contact Person
Title
City
State
ZIP Code

Charitable Sponsorship Level

I, on behalf of the above named company, agree to provide a sponsoring donation to Dementia Spotlight Foundation and will provide a company logo, support testimonial (why I am participating), and contact information that can be shared on website, social media, and other supporting promotional materials.

Please check this box to indicate that you agree with the statement above.
My sponsor commitment:
Today's Date
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