SPONSORSHIP AND UNDERWRITING PLEDGE FORM
Sponsorship Title Sponsor — SOLD
Please Print Legibly
Name: _ _______________________________________________
____ 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 ____ Dinner......................................... $20,000 ____ Ballroom Décor............................. $15,000 ____ Welcome Reception ...................... $15,000 ____ Entertainment ............................. $10,000 ____ Premium Wine.............................. $10,000 ____ Floral.......................................... $7,500 ____ Red Carpet Photography................ SOLD ____ Valet Parking................................ $5,000 ____ Champagne.................................. SOLD ____ Bar............................................. $2,000 ____ Crystal Awards............................. $2,000 Ticket(s) ____ Table of Ten (non-sponsored)......... $3,500 ____ Individual Ticket........................... $350 Program Ad Sponsorship ____ Full-Page Program Ad.................... $2,000 ____ Half-Page Program Ad.................... $1,000 ____ Quarter-Page Program Ad.............. $500
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 2/9/2026)
Confi rm pledge commitment by signing below:
Signature: _____________________________ Date: _______
____ General Donation ....................... $ __________
For stock donations, please contact the events office at (562) 933-4483 or eventsmmcf@memorialcare.org 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
Please designate my support to the following dancer(s): Torin Cunningham, MD and Carol Cunningham, NP Janet Dockstader Deborah Finklestein, MD Katie Jakemer Sumer Temple
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