Please enable JavaScript in your browser to complete this form.Sponsor Level & Amount: *$10,000 | Presenting "Salt" Sponsor$7,000 | Defender of Life$5,000 | Guardian of Life$3,000 | Champion of Life$1,500 | Friend of Life$750 | Patron of Life$500 | Crusader of Life$250 | Supporter of LifeSponsor Name: *Contact Name: *Email: *Phone Number: *Will you be mailing a check? //// Mail to: Chester County Connect Care 1028 E Lincoln Highway Coatesville, PA 19320 Attn: COL Sponsor *YesNoWill you be paying online? //// Venmo: @CCconnectcare139 or https://ccwsmedical.networkforgood.com/projects/74519-2023-celebration-of-life (MUST COPY AND PASTE ADDRESS INTO YOUR BROWSER) *YesNoI will email my artwork to Nicole@ccconnectcare.org by March 20 *Yes!I will send my payment by March 20 to assure entitlement fulfillment *Yes!Submit