Individual Patrons

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Patrons are individuals looking to sponsor other members of Impact 100. This is above and beyond their own membership payments.

The recognition levels are:

	Champion	Guardian	Steward
Donation Amount	Up to $500	$1000	$1500
Printed Program Recognition	◆	◆	◆
Website Recognition	◆	◆	◆
Newsletter Listing (quarterly)	◆	◆	◆
Tickets to Annual Meeting (2)			◆

First Name *

Middle Name

Last Name *

Email *

Phone *

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Address Line 2

City

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Zip/Postal Code

Country

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Cardholder Last Name *

Cardholder Email

Card *

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Billing address is the same as mailing address

Address Line 1

Address Line 2

City

State/Province

Zip *

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Please select donation amount.

I will mail in a check or money order

Please mail your payment to:
526 W. 14th St
STE 264
Traverse City, MI 49684

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