Name *

First Name

Last Name

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

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SPONSORSHIP: *

Please select which sponsorship option you're interested in:

Bronze Sponsorship $250

Silver Sponsorship $500

Gold Sponsorship $700

In-Kind Sponsorship $150 Value

Exclusive Sponsorship

FORM OF PAYMENT *

Please select the form of payment

CHEQUE, please address to "Wasagaming Community Arts"

E-TRANSFER, please send to wasagamingartstreasurer@gmail.com. Security Question: What is the name of your family pet? Answer: Brownie