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 (one-time and installment options available).
(Visit www.havenhousenc.org/partners for online payment form)
Please invoice me on: (Enter date)
You may expect payment on: (Enter date)
Payment must be received by 5/31/24
Impact Partner Pledge Form 2024
Mission Maker ($25,000)
Gamechanger ($10,000)
Champion ($5,000)
Leader ($2,500)
Ally ($1,000)
Friend ($500)
Decline team slots for Battle of the Bags
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 5/1/2024 to receive recognition on
the Battle of the Bags t-shirt and other promotional materials or social media. Thank you!
An online version of this form is located at www.havenhousenc.org/partner
we pledge our
contribution to be
a 2024 partner:
Print Name: