Name
Address
City, State, Zip
E-Mail Address
Telephone
Fax Number

Level of Individual Sponsorship (select one)

Bronze ( $25 - $99 )
Silver ( $100 - $249 ) - incl. 1 ticket to 2007 Induction Ceremony
Gold ( $250 - $499 ) - incl. 2 tickets to 2007 Induction Ceremony
Diamond ( $500 and above ) - incl. 3 tickets to 2007 Induction Ceremony
                                   
After submitting this form online, please mail your contribution to:
          NCTHF
          P O Box 37191
          Raleigh, NC 27627-7191

BENEFITS OF INDIVIDUAL SPONSORSHIP
     -  Eligible for representation on the NCTHF Board of Directors
     -  Name displayed (at a minimum): at all NCTHF exhibits, on
          the NCTHF website; and in all NCTHF newsletters and other
          publications (level of sponsorship will be indicated); and
     -  Preferential registration and seating at annual induction
          ceremony.