Deuces Wild! Dueling Pianos Sponsor Form The Ames Foundation’s Annual Fundraising Event

Friday, November 1, 2013 | 7:00 – 10:00 p.m. CPMI Event Center | Iowa State University Research Park

Sponsorships: $2,500 Level

• 2 Premium Reserved tables • Sponsor recognition in event

publications/signage • 20 tickets to performance • 2 complimentary drink tickets per person

$1,000 Level

• Premium Reserved table • Sponsor recognition in event publications/signage • 10 tickets to performance • 2 complimentary drink tickets per person

$500 Level

• Reserved Seating • Sponsor recognition in program • 8 tickets to performance

$250 Level

• Sponsor recognition in program • 4 tickets to performance

$100 Level

• Sponsor recognition in program • 2 tickets to performance

Name of Sponsor ________________________________________________________ Level $ ______________________ Address _____________________________________________________________________________________________ Contact (if different than Sponsor Name) __________________________________________________________________ Phone _________________________________________ Email _______________________________________________ Please find a check for $ __________ enclosed and made payable to The Ames Foundation (PO Box 213, Ames IA 50010). Credit Card option: □ Visa □ MasterCard □ Amer. Exp. Card No. __________________________________________ Exp. Date____/_____ Security Code___________ Signature: _________________________________________ NOTE: The amount of the contribution that is deductible for federal income tax purposes will be determined by current IRS regulations. While we ask that the sponsor form be returned at your earliest convenience, payment may be submitted at any time before September 15, 2013, either by cash, check or credit card.