WNYESA Summer Bash Wednesday, July 12, 2023 at 5:30 pm Buffalo RiverWorks, 359 Ganson Street, Buffalo, NY Register Prefer to Print?Sponsorship Registration Download the Form Print & Fill Email: cindiw@wnyesa.net View Sponsorship Package Details Download the Form "*" indicates required fields Company Name* Company Representative* Phone*Email* Company Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Sponsor Packages*Gold: $500Silver - $400Bronze - $300Payment Type*Choose OneCredit CardCheckCredit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Security Code Cardholder Name Payment Terms* I agree to the payment policy.By registering for sponsorship, you agree to be invoiced by the NYELSA with payment due within 30 days. You may also call our office to pay by credit card: 716-632-2023 or make Check payable to: WNYESA, or Fax Credit Card payment to 716-632-1156 Attn: Cindi, OR scan & email this completed form to: cindiw@wnyesa.netTotal CAPTCHAEmailThis field is for validation purposes and should be left unchanged.
