Form - DBSA New Jersey

Transcription

Form - DBSA New Jersey
Please Help Support Our
Ninth Annual Conference
DBSA New Jersey will hold our Ninth Annual Conference on August 8, 2015 at the
University Medical Center of Princeton, Plainsboro, NJ. The conference, centered
on mental health wellness, is open to support group participants free of charge.
Please help us pay our expenses by donating at our “crowdfunding” site,
https://fundrazr.com/campaigns/dydu0, or by completing and mailing the form
below. Donors who give $25 or more will be recognized as sponsors in our
conference program (please indicate if you wish to remain anonymous). Our goal
is to reach 125 such donations. Thank you.
Sponsorship Form for DBSA New Jersey’s Ninth Annual Conference
Name:
(as you wish it to appear in the Conference Program)
Please check if you would like to remain anonymous. Your name will not be listed in the program.
Phone:
E-mail:
Address:
City, State, Zip Code:
Gift Amount:
Donors of $25 or more will be recognized as sponsors in the program.
Checks may be made payable to DBSA NJ. Please send this form and your donation to:
DBSA New Jersey
C/O Mark Boginsky, Treasurer
1 Stoney Hill Place
Livingston NJ 07039
If you prefer to send your donation through your
bank, please type “2015 Conference” in the Memo
field. Our phone number is 1-888-829-2483.
Thank you.
The Depression and Bipolar Support Alliance New Jersey is a registered non-profit organization with the Internal
Revenue Service of the United States under section 501(c)(3) of the Internal Revenue Code.

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