(print this form and mail to address below*)
2012 PLA sponsorship form
PRO-LIFE AD SPONSORSHIP FORM
ADVERTISING RELEASE
DEADLINE: Jan. 17, 2011 DEADLINE: Jan. 17, 2011
The undersigned hereby gives permission to use my name in the Pro-Life newspaper advertisement on behalf of: Nevada Eagle Forum/Nevada Families, and the Choose Life Coalition.
SIGNATURE HERE:
Signed___________________________________________________Date______________________
Address____________________________________________________________________________
City___________________________________________State____________Zip__________________
Phone___________________________________(h)________________________________________fax
E-mail_______________________________________________________________________________
I want my name to appear in the ad as follows: Examples: The John Doe Family, Mr. and Mrs. John Doe, or John and Mary Doe, or the name of an organization, business, or church may be used.
PRINT NAME HERE: _________________________________________________
Please print name(s) exactly as it should appear in the paper.
Donation: $25____ $50____ $100____ $250____ $500____ Other $______
_____Check here if you want to donate, but DO NOT want your name in the paper.
Please make checks payable to:
Nevada Eagle Forum (not tax deductible) or Nevada Families (tax deductible):
Deadline: January 17th
*MAIL: by January 13th to 186 Ryndon Unit 12, Elko, Nevada 89801
FAX form: by January 17th Elko 775-753-6397, Sparks phone/fax 775-356-0105 & mail your check.
WEBSITE: www.nevadafamilies.org Contribute on line. Be sure to notify us by email at:
EMAIL: director@nevadafamilies.org
DELIVER: to Lynn Chapman 815 Glen Vista Dr. Sparks, NV 89434, 356-0105.
CALL: 775-397-6859 or in Sparks 775-356-0105
Please RETURN this entire sheet WITH YOUR CHECK
The ad will appear on or near Sunday, Jan. 22ndin the various newspapers. The cost of the full- page color ad in the various Nevada newspapers will be over $6,000. Your donations above the $25 are greatly appreciated and will help with additional costs.
“Choose Life--that you and your descendants may live.”