$15,000 Dinner Sponsor



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$15,000 Dinner Sponsor - Post-Event Thank you - Logo on Invitation - Link to sponsor s Website Opportunity to Speak at Podium 2 Full Page Ads in Program 2 Tables of Ten - Priority Seating - Prominent Signage - Customized with your Honoree Media Recognition - Ads, Press Releases, Feature Stories Spotlight in looped DVD presentation on Flat Screen

$10,000 Reception Sponsor - Post-Event Thank you - Logo on Invitation - Link to sponsor s Website Opportunity to Speak at Podium Full Page Ad in Program Table of Ten - Priority Seating - Prominent Signage - Customized with your Honoree Media Recognition - Ads, Press Releases, Feature Stories Spotlight in looped DVD presentation on Flat Screen

$7,500 Celebration Sponsor - Post-Event Thank you - Logo on Invitation - Link to sponsor s Website Opportunity to Speak at Podium 3/4 Page Ad in Program Table of Ten - Priority Seating - Prominent Signage - Customized with your Honoree Media Recognition - Ads, Press Releases, Feature Stories Spotlight in looped DVD presentation on Flat Screen

$5,000 Commemorative - Post-Event Thank you - Logo on Invitation Half Page Ad in Program Full Table of Eight - Preferred Seating - Customized with your Honoree Media Recognition Spotlight in looped DVD presentation on Flat Screen

$3,000 Tribute - Post-Event Thank you 1/3 Page Ad in Program Full Table of Eight - Preferred Seating - Customized with your Honoree Spotlight in looped DVD presentation on Flat Screen

$1,500 Benefactor - Name on Sponsor Page in Program 1/4 Page Ad in Program Full Table of Eight - Reserved Seating Listing in looped DVD presentation on Flat Screen

$1,000 Foundation - Name on Sponsor Page in Program 1/4 Page Ad in Program Table of Eight - Reserved Seating Listing in looped DVD presentation on Flat Screen $500 Friend Sponsor - Name on Sponsor Page in Program Four Tickets - Reserved Seating Listing in looped DVD presentation on Flat Screen

$300 Supporting Sponsor - Listing in Event Program Two Tickets - Reserved Seating Listing in looped DVD presentation on Flat Screen $100 Supporting Sponsor - Listing in Event Program One Ticket - Reserved Seating Listing in looped DVD presentation on Flat Screen $50 Individual Tickets

Company/Organization: Company Representative: Address: City, ST, Zip: Phone: Fax: Email: Please indicate your sponsorship selection: TITLE: BRANDON REGIONAL HOSPITAL and the PHYSICIANS OF BRANDON REGIONAL HOSPITAL & SOUTH BAY HOSPITAL and the PHYSICIANS OF SOUTH BAY HOSPITAL 0 $15,000 Dinner Sponsor 0 $10,000 REception Sponsor 0 $7,500 Celebration Sponsor 0 $5,000 Commemorative 0 $3,000 Tribute 0 $1,500 Benefactor 0 $1,000 Foundation 0 $500 Friend Sponsor 0 $300 Supporting Sponsor 0 $100 Supporting Sponsor 0 $50 Individual Tickets x $50 Total $ Payment Information: Amount Enclosed $ (make checks payable to Brandon Foundation) Please charge: 0 Visa 0 MC 0 AMEX 0 Discover # Exp. CVV Sig: Payment to be received by Nov. 5, 2015 to be included in print materials; by Nov. 12, 2015 to be included in program. Ad sizes included on following page. Please email logos in eps, png, or jpg format - high resolution (300 dpi) to info@brandonfoundation.com. Commitment: Upon receiving this signed commitment form, we will reserve your sponsorship opportunity and you should receive a confirmation letter within 5 business days. This form must be submitted to the Brandon Foundation office in order to receive recognition on event collateral and signage. Signature Date Please mail to: Brandon Foundation, P.O. Box 3197, Brandon, FL 33511. Ph: 813-689-6889 Fax: 813-464-2885 Contact: Rosemarie Smith, Executive Assistant Rose@brandonfoundation.org www.brandonfoundation.org

Ads are printed in full color: CMYK mode; 300 dpi - Print resolution. Format:PDF, Tiff, EPS, JPG, PSD Please do not send artwork clipped from websites/internet/etc. The Brandon Foundation can prepare ads upon request. Please allow 7 additional working days before ad deadline for proof and approval of artwork. Email: info@brandonfoundation.com Panels shown are not Actual Size Please prepare ads to the following specs: trim line safe area Full page ad with bleed: 5.625 w x 8.625 H Full page ad no bleed: 5.0 w x 8 H 3/4 page ad: 5.0 w x 5.85 H Half page: 5.0 w x 4.0 H 1/4 page ad vertical: 2.45 w x 3.85 H trim line 5.625 W x 8.625 H trim line 5.0 W x 8.0 H Full page ad 1/4 page ad horizontal: 5.0 w x 2.0 H 1/3 page ad horizontal: 5.0 w x 2.6 H safe area trim line 5 W x 2 H Horizontal 1/4 page ad 2.45 W x 3.85 H Vertical 1/4 page ad 5.0 W x 2.6 H Horizontal 1/3 page ad 5.0 W x 2.6 H Horizontal 1/3 page ad 5.0 W x 5.85 H Vertical 3/4 page ad 5.0 W x 4.0 H Horizontal 1/2 page ad 5.0 W x 2.6 H Horizontal 1/3 page ad