Business Name*

Your Name*

Please enter the name of the individual authorizing payment for the AVFRD Sponsorship program.

First Last

Your Title*

Please enter your title/position in your business.

Business Address*

Street Address Address Line 2 City State ZIP Code

Business Phone*

Business Website

Business Email*

Subscribe me to your email newsletter

Business Twitter Handle

Share your business Twitter handle so we can publicly thank you for your support.

Business Facebook Page

Share your business Facebook page so we can publicly thank you for your support.

Payment Interval*

Please select your payment interval

Monthly Sponsorship Level*

Please choose your monthly sponsorship level.

Annual Sponsorship Level*

Please select your annual sponsorship level.

One-Time Sponsorship*

Please enter the amount of your on-time sponsorship donation.

5k Race Sponsorship*

Old Ox Chili Sponsorship*

Total

$0.00

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

CAPTCHA

Monthly Pancake Breakfast

Prospective Member Meeting