Marin CASA’s 2019 Harvest of Hope: Changing Lives 17 OCTOBER Mill Valley Community Center Wine and Music: 6:00 – 7:15pm Dinner and Live Auction: 7:15 – 9:30pm Sponsorship Form First Name*Last Name*Company Name (if applicable)Company Contact (if applicable)Email* Phone*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Sponsorship*Harvest Level (Main Sponsor): $15,000Farm Level: $10,000Garden Level: $5,000Table Sponsor: $3,000Individual Ticket: $250 Check here if you require a vegetarian meal # of vegetarianHost Committee Yes, I want to sponsor before July 25th and be on the host committee Number of Tickets12345678910A 3% credit card processing fee will be added to your online purchase. You may also send a check payable to the following address: Marin CASA 1401 Los Gamos Drive, Suite #130 San Rafael, CA 94903 Attn: Mike CosbyHelp Us Cover CostsYes! I want 100% to go to Marin CASA (3% credit card processing fee)No. I will donate, but please have Marin CASA cover the processing costs.Simply leave “Yes!” checked to ensure that 100% of your intended sponsorship is available for our mission.Credit Card* DiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name Processing Amount* Price: $0.00 Processing Amount* Price: $0.00 Processing Amount* Price: This Sponsorship is in Honor of:This Sponsorship is in Memory of:If your gift is in honor or memory of someone, to whom and to where would you like us to send a notification? This is from:Special Comments:CommentsThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms. Marin CASA is a 501 (c)(3) tax exempt organization. Our Federal tax identification number is 81-5047208.