2013 Texas Walk for Brain Injury Sponsorship Brochure

Sponsorship Form

Your contact information Select One: q Mr. q Mrs. q Ms. q Mr. and Mrs. q Dr. q Other NameCompany Street Address City, State, ZIP CountryE-mailPhoneSpecial Instructions Signature

Benefits for various levels detailed on SPONSOR BENEFITS PAGE q $ 1,500 1 or more single site(s) q $35,000 All Walk sites statewide

q $10,000 1 or more selected site(s) q $ 3,500 1 or more single site(s)

q $ 500 Commercial exhibitor per site q $ 150 Nonprofit exhibitor per site

q $ 250 Logo on video board, path signs q IN-KIND (See In-Kind form on reverse) q OTHER $

Grand Prairie • Sugar Land • Round Rock • San Antonio

Brain Injury Association of America

1. Select the Walk for Brain injury location(s) you wish to sponsor2. Mail: BIAA – Texas Division, P.O. Box 95234, Grapevine, TX 76099-97523. Make checks payable to Brain Injury Association of America – Texas Division (Tax ID 4-2716222)4. BIAA – Texas Division will e-mail you a receipt.

Check enclosed for $

PREFER TO PAY SPONSORSHIP BY CREDIT CARD? To pay by credit card, please visit www.biausa.org and select the green Donate and Support button on the left side. To comply with PCI regulations which have been designed by the credit card industry to reduce the potential that your credit card data will be stolen, credit card donations must be made through our secure website at www.biausa.org. MasterCard, VISA, Discover and American Express are accepted.

Contact name and e-mail for benefit details / logo: Please send your organization’s logo in jpg format to Bill Roof, Director, BIAA – Texas Division, at [email protected] no later than Jan. 23, 2013, to ensure inclusion in Walk brochure. Questions: 512-944-3566 or 703-761-0750 X:644

Round Rock (Metro Austin) March 9 Grand Prairie (DFW) March 23Sugar Land (Metro Houston) March 16San Antonio Fall

In-Kind Donation

Donation and Donor InformationI/we wish to donate the items listed for the location(s) selected.

Estimated Value of Donation $___________________ Date of Donation ___________________

Select One: q Mr. q Mrs. q Ms. q Mr. and Mrs. q Dr. q Other NameCompanyStreet AddressCity, State, ZIPCountryE-mailPhoneSpecial InstructionsSignature

Email [email protected] FAX 703-761-0755 Mail Bill RoofBIAA – Texas DivisionPO Box 95234Grapevine, TX 76099-9752

Thank you again for your generous gift. Together we are making a difference for individuals with brain injuries in Texas.

The Internal Revenue Service (IRS) requires, for our records and yours, that an estimation of the dollar amount of a non-cash contribution be given. The estimation must be made by

the donor. IRS publication 563, Determining the Value of Donated Property is helpful for individuals, partnerships and corporations which make non-cash contributions. If a non-cash

contribution exceeds $5,000, the taxpayer must file IRS form 8283.

Grand Prairie • Sugar Land • Round Rock • San Antonio

Brain Injury Association of America

Please select the location(s) for your in-kind donation

Thank you for your in-kind donation for the Texas Walk for Brain Injury at the location(s) checked below. This form will help us properly record and acknowledge your generous gift. If you have any questions, please contact Bill Roof, Director, BIAA – Texas Division at [email protected] or 512-944-3566 or 703-761-0750 X:644

Please send this form to BIAA – Texas Division, A Walk for Brain Injury volunteer will contact you regarding donation arrangements.

Round Rock (Metro Austin) March 9 Grand Prairie (DFW) March 23Sugar Land (Metro Houston) March 16San Antonio Fall