New Albany Independence Day 5K Sponsor Form To pay by check, download the sponsor information form. Name* First Last Company Name Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email* PhoneLogo or Name for Recognition?*Please send a high-resolution version of your logo with a transparent background to asproule@newalbanysymphony.com.Select OneLogoNameAnonymousName for RecognitionName, family, business, group or in memoriumSponsorship LevelPresenting 5K Race Sponsor $7500Platinum Sponsor $5000Pet Parade Sponsor $2500Gold Sponsor $2000Silver Sponsor $1000Bronze Sponsor $500Community Sponsor $250Flag Sponsor $100In-kind DonationIn-Kind Donation DetailsPlease tell us what you are donating and any instructions regarding pickup or delivery.Payment MethodIf paying by check, please make it payable to New Albany Symphony and mail it to PO Box 332, New Albany, OH 43054. If paying online via debit or credit card, you can make your payment after submitting this form.Choose OneOnline via Debit or Credit CardCheck - Invoice RequestedCheck - No Invoice NeededAmount Total $0.00 Credit CardCard Details Cardholder Name CAPTCHA