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AMIA 30th Anniversary
Please verify reCaptcha before submitting the form.
Co-Sponsoring Organization:
A tax-deductible contribution of
$300
entitles your institution to have its name/logo on the event's e-flyer and program, displayed on screen at the event, and acknowledged during the program. Two representatives designated by you will be invited to light candles during the memorial ceremony.
Participating Organization:
A tax-deductible contribution of
$100
entitles your organization to have its name included on the event's e-flyer and program and displayed on screen at the event. A representative designated by you will be invited to light candles during the memorial ceremony.
Organization Name
Phone
Address 1
Apt Number if Applicable
City
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
Email
Please select sponsorship amount
Select
Co-Sponsor $300 with Logo
Participating Organization $100 name only
Co-Sponsoring Organization ONLY please upload logo here.
You can upload a maximum of 1 files.
Wed, April 30 2025 2 Iyyar 5785