Hershey News Years Celebration

FIREWORKS SPONSORSHIP FORM

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Complete and mail this form to:
Community Celebration Committee, PO Box 41, Hershey, PA 17033

Make checks payable to: Community Celebration Committee

Personal Information

Business Name
if applicable

Contact Person

Address 1

Address 2

City

State

Zip

Day Phone

Evening Phone

Email

Signature

Description	Name to be recognized	Donation	Quantity	Sub-Total
Noise Maker		$ 25.00
Winter Wonder		$ 50.00
Midnight Kiss		$ 100.00
Sweet Celebration		$ 150.00
Fantastic Finale		$ 250.00
			Grand Total	$

Payment Information

Check Number: Amount Enclosed   $