Nutty Nutcracker Sponsorship Commitment Form

The Leukemia & Lymphoma Society’s 3rd Annual Nutty Nutcracker Sunday, December 13, 2009 Presented by Xtreme Dance Studio at Lake Mary Performing Arts, Lake Mary Thank you for participating in the 2009 Nutty Nutcracker! Please complete all four sections of this form to ensure proper representation of your company’s name on all printed materials associated with the Nutty Nutcracker

-Section 1SPONSORSHIP OPPORTUNITIES _____ Nutcracker Sponsor $1,000 (includes 8 VIP tickets and full page ad in the program) ____ Poinsettia Sponsor $750 (includes 6 VIP tickets and half page ad in the program) ____ Evergreen Sponsor $500 (includes 4 VIP tickets and ¼ page ad in the program) ____ Candy Cane Sponsor $250 (includes 2 VIP tickets and ¼ page ad in the program) ____ VIP tickets $25 (includes reserved seating) ____ Adult tickets $10 ____ Children $5

OTHER OPPORTUNITIES We are not able to sponsor the Nutty Nutcracker this year, but would like to make a tax-deductible contribution to The Leukemia & Lymphoma Society of $_____________.

-Section 2____ We are unable to use our Nutty Nutcracker tickets. Please donate them to a blood cancer patient and/or family. ____ We would like to donate ______(number) tickets since we are unable to use all of our tickets.

-Section 3SPONSOR CONTACT INFORMATION (please print) Name of Sponsor (as you would like it to appear on printed materials) __________________________________________________________________________________________________ Contact Name: ______________________________________________ Title: _________________________________ Address: __________________________________________________________________________________________ City: _________________________________________________ State: ___________ Zip: _____________________ Phone: ________________ Fax: _________________ Email: ______________________________________________

-Section 4PAYMENT INFORMATION:

All payments due by NOVEMBER 16, 2009 for printing deadline.

_____ Check enclosed (please make payable to The Leukemia & Lymphoma Society) _____ Check sent by: ___________________________________________ _____ Please charge the following credit card in the amount of $___________. ___ Visa

___ AMEX

___MC

___Discover

Acct #:__________________________________________ Exp. Date:_______ V Code:______ Signature:______________________________________________________________________ FOR MORE INFORMATION CONTACT: SHERI METCALF – XTREME DANCE STUDIO 4932 W SR 46, SUITE 1048 ▪ SANFORD, FL 32771 ▪ 407-330-7002 ▪ [email protected] OR

MARY HEALEY – THE LEUKEMIA & LYMPHOMA SOCIETY 3319 MAGUIRE BLVD., STE. #101 ▪ ORLANDO, FL 32803 ▪ 407-898-0733 ▪ [email protected]