SPONSORSHIP AND UNDERWRITING PLEDGE FORM
SPONSORSHIP
PLEASE PRINT LEGIBLY
Title Sponsor — SOLD ____ Swing Sponsor........................... $30,000 ____ Quickstep Sponsor..................... $20,000 ____ Tango Sponsor........................... $10,000 ____ Salsa Sponsor............................ $7,500 ____ Cha-Cha Sponsor....................... $5,000 ____ Foxtrot Sponsor......................... $2,500 UNDERWRITING (100% tax deductible) ____ Dinner (four available).................. $20,000/each ____ Ballroom Décor............................ $15,000 ____ Welcome Reception ..................... $15,000 ____ Entertainment ............................ $10,000 ____ Premium Wine............................. $10,000 ____ Floral......................................... $7,500 ____ Red Carpet Photography............... $5,000 ____ Valet Parking............................... $5,000 ____ Champagne................................. $2,500 ____ Bar (six available)........................ $2,000/each ____ Crystal Awards............................ $2,000 PROGRAM AD SPONSORSHIP ____ Full-Page Program Ad................... $2,000 ____ Half-Page Program Ad.................. $1,000 ____ Quarter-Page Program Ad............. $500
Name: _ _______________________________________________
Preferred recognition name (for printed materials): _____________________________________________________ Address:_ ______________________________________________ _____________________________________________________ Phone:___________________ Email:______________________ Payment enclosed by check payable to: Memorial Medical Center Foundation Payment enclosed by credit card
Name on credit card:_____________________________________
Billing address:________________________________________
_____________________________________________________
City: ________________________ State: _____ ZIP:_______
Card type: Visa ®
Mastercard ®
American Express ®
Card#: _____________________________________________
Expiration date: ________________________ CVV:________
Please accept my pledge of $________________________ (To be paid by 2/5/2027)
____ General Donation ...................... $ __________
Confirm pledge commitment by signing below:
PLEASE DESIGNATE MY SUPPORT TO THE FOLLOWING DANCER(S): Jacqueline “Jackie” Apuzzo Lucy Crumrine Mark & Claire Guillen Alfredo & Laura Velasco Dr. Andrew & Miray Wassef
Signature: _____________________________ Date: _______ For questions about making your gift through a Donor Advised Fund, or a non-cash gift such as appreciated stock, or through your IRA, etc., please contact our Events Office at (562) 933-4483 or eventsmmcf@memorialcare.org. We are happy to assist in structuring your support in a way that aligns with applicable guidelines. MemorialCare Long Beach Medical Center and Miller Children's & Women’s Hospital are community-based, non-profit hospitals. Contributions made to Memorial Medical Center Foundation are tax-deductible to the fullest extent allowed by the law. IRC section 501(c)(3) Tax ID #95-6105984
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