Sponsorship Commitment Form

Thank you for agreeing to become a sponsor for one of our programs. Please fill out the form below.

Sponsorship Commitment Form

"*" indicates required fields

Yes! We are proud to support the Washington Poison Center with the following:*

We authorize the Washington Poison Center to include our name and/or logo on all the materials and digital content consistent with our sponsorship selection below*

Level of Sponsorship/Donation:*

Other Amount:

Company Name:*

Contact Name:*

Address*

Address 2

City*

State*

Zip*

Phone*

Email*

Please indicate:*

Check enclosed (please make payable to Washington Poison Center)

Credit card payments (accepted online at https://www.wapc.org/support-us/donations/individual-donations-2/)

Please send me an invoice

Please mail sponsorship checks to:

Washington Poison Center
155 NE 100th St., Suite 100
Seattle, WA 98125

For more information on sponsorship availability, to customize benefits packages, or for general questions, please contact Michele Meaker@wapc.org or at 206-517-2355.