PARTNERSHIP ORDER FORM
2011
1007 PROSPECT DRIVE, PO BOX 22 TOLEDO, IA 52342 (641) 484-3108 INFO@TAMACOUNTYIOWA.ORG WWW.TAMACOUNTYIOWA.ORG
For the year starting May 1, 2011 A response is appreciated by June 1, 2011
PLEASE CONFIRM THAT OUR INFORMATION ABOUT YOU IS UP TO DATE: (CORRECT ON THIS FORM WHERE NEEDED)
FEDERAL ID# 42-6005285 DATE: April 27, 2011
NAME: ORGANIZATION: ADDRESS: PHONE: EMAIL: WEBSITE:
I would be willing to serve on a brain trust committee relevant to my industry expertise or personal community interests. Please also email other employees/volunteers with our organization (please list on back) Attached is a synopsis of our organization to help promote us Please email me time sensitive industry relevant opportunities
PLEASE MARK DESIRED PARTNERSHIP LEVEL PLATINUM
GOLD
SILVER
BRONZE
$1,000
$500
$250
$100
Checks payable to “Tama County Economic Development”
PARTNER’S DIRECT BENEFITS INCLUDE (but are not limited to): Featured in online directory Free website hosting and programming Blog contributor option Published directory Starred consideration industry reference requests Opportunity to advertise in Tama County Connections Magazine Voting and nomination opportunity on the 24 featured faces of Tama County Partnership certificate
PRINT NAME
SIGNATURE
DATE
THANK YOU FOR YOUR CONTRIBUTION IN DEVELOPING TAMA COUNTY’S ECONOMIC & COMMUNITY BASE