Please choose your Sponsorship Level below:
Donation Information
Amount
Vegas Nights Band Sponsor - $5,000
Highstakes Wine Pull Sponsor - $5,000
Red Carpet Sponsor - $5,000
Lights, Camera, Action Sponsor - $3,000
007 Signature Cocktail Sponsor - $3,000
Blackjack Sponsor - $3,000
Royal Flush Bar Sponsor - $3,000
Craps Sponsor - $2,000
Roulette Rush Sponsor - $2,000
Club Decor Sponsor - $600
Diamond Decor Sponsor - $600
Type of Donation
One Time Donation
Recurring Donation
Frequency
Monthly
Contact Information
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Last Name
Company Name
Address
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Help Us Cover Costs
Simply leave "Yes!" checked below to ensure that 100% of your intended donation is available for our mission.
Yes! I want $0.00 to go to Discovery Science Place and I will donate $0.00.
No. I will donate $0.00 and Discovery Science Place will cover the processing costs.
Payment Information
I will mail a check for my sponsorship.
Please send me an invoice for my sponsorship donation.
Payment Options
Credit Card
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Credit Card Information
Card Holder Name
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Card Account Number
Expiration Date
Month
01
02
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04
05
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07
08
09
10
11
12
Year
24
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Security Code
Billing Address
Same As Above
Address
City
State/Province
Alabama
Alaska
Alberta
Arizona
Arkansas
Armed Forces Americas
Armed Forces Other
Armed Forces Pacific
British Columbia
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland and Labrador
North Carolina
North Dakota
Northwest Territories
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington DC
West Virginia
Wisconsin
Wyoming
Yukon
Zip/Postal Code
Email
Your entry is not a valid email address!
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