Haven House Services 2025 Impact Partner Program

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Check is enclosed in the amount of: $

(Please make checks payable to Haven House Services)

Company/individual name:

(name as it should appear in print)

Primary Contact & Title:

Mailing Address:

Phone:

Email:

Signature:

Date:

City:

State:

Zip:

I have submitted payment online for my sponsorship.

(Visit www.havenhousenc.org/partner for online payment form)

Please invoice me on: (Enter date)

You may expect payment on: (Enter date)

Payment must be received by 5/2/25

Impact Partner

Pledge Form 2025

Mission Maker ($50,000)

Guardian ($25,000)

Gamechanger ($10,000)

Champion ($5,000)

Leader ($2,500)

Advocate ($1,000)

I/we decline team slots for Battle of the Bags event

PAYMENT INFORMATION

CONTACT INFORMATION

I, the undersigned, am an authorized representative of the above-named company and give Haven House Services

permission to use the company name I print and promotional materials as appropriate, based on the amount of the

donation and agreement of benefits.

PLEASE MAIL OR SCAN AND EMAIL THIS FORM TO:

Shannon Walters, Chief Development Officer, at swalters@havenhousenc.org

1008 Bullard Court, Raleigh, NC 27615

All Impact Partners must email a hi-resolution color version and a one-color, all white version of your logo (.ai, .eps, .jpg, or .pdf format) to

swalters@havenhousenc.org by 5/1/2025 to receive recognition on the Battle of the Bags t-shirt and other promotional materials or social media.

Tax ID: 56-1073632 NC Charitable Solicitation License:SL000906

Financial information about this organization and a copy of its license are available from the State

Solicitation Licensing Branch at 919-814-5400. The license is not an endorsement by the State.

Scan QR code or go to www.havenhousenc.org/partner

for an online version of this form

We pledge our contribution

to be a 2025 partner:

Print Name:

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