NAME *

First Name

Last Name

Address

Address 1

Address 2

City

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Zip/Postal Code

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YOUR PHONE NUMBER *

Please provide your phone number?

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WHO IS DESIGNING YOUR AD? *

I AM DESIGNING MY AD

I WANT BIRTHDAY COMMITTEE TO DESIGN MY AD

SOMEONE ELSE IS DESIGNING MY AD

SPONSORSHIP OPPORTUNITY:

PLATINUM $900 (Includes a full-page ad, two autographed special editions of On the Potter’s Wheel, by Bishop Dixon, and a Souvenir Book)

DIAMOND $450 (Includes a half-page ad, an autographed special edition of On the Potter’s Wheel by Bishop Dixon, and a Souvenir Book)

GOLD $270 (includes a quarter-page ad, an autographed special edition of On the Potter’s Wheel by Bishop Dixon, and a Souvenir Book)

SILVER $90 (Named on the Sponsorship Page, and a Souvenir Book)

AD SIZE

Please Select your Ad size below. If Selecting Patron List Option please write the name exactly as you would want it to appear below.

Full Page - $200.00

Half Page - $ 155.00

Quarter Page - $75.00

Birthday Greetings - $ 25.00

PAYMENT METHODS *

Please tell us how you are paying for your Ad? Payments made by mail will be acknowledged once the check has cleared.

SoCal 4th Jurisdiction Website

Givelify

Mailing in Check or Money Order