2011 Muscatine Charities, Inc. -- Donor Response Form

Name or Company Name as you would like it to appear on any printed materials:

Your Name:

Corporate Sponsor

$10,000+

Major Event Sponsor

$5,000

Adopt a Child Sponsor

$2,500

Double Eagle Sponsor

$2,000

Hole-in-One Sponsor

$1,500

Eagle Sponsor

$1,000

Birdie Sponsor

$500

Par Sponsor

$250

Community Sponsor

$100

Other

$_______

You and your company will be listed in the dinner banquet brochure and in newsprint following the event. Please note there is a June 15, 2011 deadline.

Credit Card: Visa:                               MasterCard:             

Name on Card:

Signature:

Card #:                                                 Expiration Date:

Please return this form with your credit card information or check to:

Muscatine Charities, Inc.

P.O. Box 973

Muscatine, IA 52761