Free Brain Injury Resource Line: 1-800-444-6443

Invidividual Donation

BIAPA SPONSORSHIP
Highmark Walk for a Healthy Community- Lehigh Valley

Thank you for your sponorship of the Brain Injury Association of Pennsylvania at the Highmark Walk for a Healthy Community - Lehigh Valley.

Sponsorship Levels:

$5,000 - Champion

$2,500 - Gold

$1,000 - Silver

$500 - Bronze

$250 - Patron

$5,000 - Champion

$2,500 - Gold

$1,000 - Silver

$500 - Bronze

$250 - Patron

First Name: Last Name: Email: Phone: Address: City: State: Zip: -

Tribute Sponsorship

If your sponsorship is in honor or memory of someone, please enter the name of the person being honored or remembered (Tribute Name).

Tribute Type: Tribute Name:

Tribute Notification

If you would like BIAPA to notify an individual or family that this sponsorship is in honor or in memory of someone, please provide the name and address of the person(s) who should be notified about your tribute. We will notify that person or their family of your generosity.

Acknowledge To: Address: City: State: Zip Code: - Comment:

This is a one time donation

Make this a recurring donation deducted

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