Shoe Locker Sponsor Pledge

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1 Step 1

Are you sponsoring as an individual or on behalf of a company?

IndividualCompany

First Name

Last Name

Phone Number

Company Name

Company Contact First Name

Company Contact Last Name

Company Contact Email

Company Contact Phone Number

Mailing Address

City

Zip

Desired City, State or School You Want to AdoptSamaritan's Feet cannot guarantee your desired school will be chosen.

Pledge

$5,000: a 250 shoe commitment$10,000: a 500 shoe commitmentOther

Other

Payment Method

Credit CardCheckInvoice

How did you hear about the Samaritan's Feet Shoe Lockers?

SignatureI agree to the above.

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