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: