PRIME PATHWAYS SPONSORSHIP REQUEST FORM (If you would prefer to fill out a paper Prime Pathways Sponsorship Request Form, Please see below to download PDF.) Sponsor Information Organization/Business Name * First Name Last Name Person/Contact Person * First Name Last Name Title/Role * First Name Last Name Email * Phone * Country (###) ### #### Mailing Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Sponsorship Level (Select One) * Gold Sponsor ($50,000+) Logo on van, top-tier recognition, media features, classroom naming opportunity Silver Sponsor ($25,000+) Logo on website, social media spotlight, quarterly reports, classroom visit invites Bronze Sponsor ($10,000 to $24,999) Thank you recognition, program update emails, social media mention Seed Sponsor ($1,000 to $9,999 , goods/services; please describe below) In-Kind Sponsor Goods/services (please describe below) Areas of Interest Mobile Classroom (Vehicle) Montessori Education Special Education / Disability Inclusion Underserved Communities Mobile Innovation / Technology Health & Wellness Other Additional Notes or Comments What interested you in Prime Pathways Program? * How did you hear about Prime Pathways? * I/we wish to support Prime Pathways and understand this contribution will directly support education access and innovation for children with disabilities and in underserved communities. Authorized Signature * I agree that by writing my full names in CAPS herein will be my legal signature for purposes of using this online Prime Pathways Sponsorship Request Form; this e-signature will have the same effect as if I had signed my name or initials manually. Today's Date * MM DD YYYY Thank you for Submitting an Admissions Application. We will review and a member of our Admissions team will reach out to you soon! If you would prefer to fill out a paper Prime Pathways Sponsorship Request Form, please download the PDF below. Prime Pathways Sponsorship Request Form PDF
