PACD Awards Program

Sponsorship/Supporter Response Form

This form is available in Word or PDF format.

Please complete the information below and submit it to the PACD Office, along with your check, made payable to "PACD" as soon as possible, but no later than June 30, 2009.

Please check (X) one of the following:
____ I wish to be considered a PACD Award Sponsor ($500). Please indicate your Award category preference:

____ I have no preference

____ Ann Rudd Saxman Conservation District Director (or Associate Director) Excellence Award

____ Conservation District Employee Excellence Award

____ Legislator Recognition Award

____ PACD President's Award

____ I wish to be considered a PACD Award Supporter ($250)

____ Other. Enclosed is my donation in the amount of (less than $250) ________.

Contact name: ___________________________________________

Business/Organization (if applicable): __________________________

Complete mailing address: __________________________________

______________________________________________________

Phone: (_____) ______________ Fax: (_____) _________________

E-mail: _________________________________________________

PACD will confirm your PACD Awards Program status promptly.

Please mail to:

PACD Conservation Awards Program
25 North Front Street
Harrisburg, PA 17101

Questions? Call 717-238-PACD (7223)