Pledge Form The Worcester District Medical Society would like to thank you for your support of our 225th Anniversary Gala. This Gala will be held on Friday, September 27, 2019 from 5:30 p.m. at the Mechanics Hall, Worcester. Below are the details of our sponsorship opportunities, the cost of placing an ad in the commemorative brochure published for the Gala, and also instructions on how you may contribute directly to the WDMS Scholarship fund, if you choose to do so. All the proceeds from this Gala, after expenses, will be donated to the WDMS Scholarship Fund.
Name:________________________________________________________________________ Address:______________________________________________________________________ Contact Person:________________________________________________________________ E-Mail:________________________________________________________________________ Telephone:____________________________________________________________________ A. Sponsors Gold: $5,000.00 – this includes: Full page ad, 8 Dinner tickets Silver: $2,500.00 – this includes: ½ page ad and 4 Dinner tickets Bronze: $1,500.00 – this includes: ¼ page ad and 2 Dinner tickets
B. Supporters (Advertisements in the brochure) Full page: $1,000.00 (Back page Color -$2000, Inside Front / Back page Color- $1500) (w6 7/8 x h10”) Half page: $500.00 (w 6 7/8” x h 4 7/8”) Quarter page: $250.00 (w 3 ½” x h 4 7/8”) Business Card: $ 125.00 (w 3 ½” h 2”)
C. Friends of the WDMS Scholarship Fund Any contribution to support the Scholarship Fund will be very much appreciated: $....................($100+ will be listed in the brochure)
Please provide WDMS with your print ready advertisement material by 9-6-2019. Please make check payable to: Worcester District Medical Society Mechanics Hall 321 Main Street , Worcester, MA 01608-1522
WDMS is a 501c3 organization: #04-6039281 Email: mwwdms@massmed.org Tel: 508-753-1579, Fax: 508-754-6246 (Please attach/enclose this form along with your check) July/August 2019 Worcester Medicine | 9
