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CELEBRATE CHIMPS SPONSORSHIP RESERVATION FORM <br />This form is your invoice, you will not be bdlea <br />t, the undersigned, herewith order from the Celebrate Chimps Committee, under the Terms of Agreement included in <br />this document, fiberglass Chimp forms to be used by a Creative Agent for participation in Celebrate Chimps and/or <br />seek to participate in Celebrate Chimps with a non-standard sponsorship that will not utilize the fiberglass chimp <br />form. <br />Signature <br />Corporate Name. <br />Contact Person. <br />Title: <br />City/State/Zip <br />Telephone: FAX. <br />SPONSORSHIP ORDERED: <br />SPONSORSHIP OPTIONS: <br />GOLD <br />S5,000.00 — Silver sponsor rights. plus <br />Swing with Sammy Party Sammy <br />Safari Clue Site. ONLY 10 AVAILABLE <br />SILVER <br />S3,500r00 —Bronze sponsor rights, plus 4 <br />tickets to Auction Gala, advertising rights for <br />your Chimp, installation and delivery, name <br />on the plaque on chimp base, tax deduction <br />of auction proceeds and chimp and artist <br />costs. <br />BRONZE <br />S1,500.00 — Listing on advertising materiafs <br />and map and website. 2 tickets to Auction <br />Gala (Does not include Chimp mold) <br />GOLD $5,000.00 LEVEL quantity = S <br />SILVER $3,500.00 LEVEL quantity = S <br />BRONZE $1500.00 LEVEL quanity = 5 <br />PLACEMENT OF CHIMPS <br />We request placement of our chimp in the following locations) on the public way <br />(subject to availability, compliance with ADA guidelines, and with the approval of appropriate <br />regulatory agencies). <br />We intend to place the chimp on private property (to which we have rights and have made all <br />necessary arrangements for access) for public display in a store window, lobby, plaza, etc... located <br />at: <br />if sponsoring chimps and providing your <br />own Creative Agent please provide <br />name(s) and contact information for <br />your Creative Agent." <br />'All creative agents are required to <br />enter into a contract with the <br />Celebrate Chimps committee <br />Creative Agent <br />Contact Name- <br />Title/Discipline <br />Address <br />City/State/Zip. <br />Telephone. Email: <br />