The Gesneriad Society Flower Award Sponsorship Form

The Gesneriad Society Flower Show Award Sponsorship Form

Use this form to make a donation by mail only.

To make a donation by mail:

Make checks or money orders payable, in US$ on a US bank to The Gesneriad Society, Inc. and submit completed application form with payment to:

Paul Lee, Awards Chairperson (email awards@gesneriadsociety.org)
6693 Second Line, RR #3
Fergus, ON, Canada N1M 2W4

To obtain additional information about making a donation to the Society, contact the Awards Chairperson, Paul Lee.

* required information

I am sponsoring a Flower Show Award:

Amount:

This award is being made In Honor of:

First Name:

Last Name:

This award is being made In Memory of:

First Name:

Last Name:

Your Information

First Name:*

Last Name:*

Email:*

Address 1:*

Address 2:

City:*

State:*

Province:

Country:

Zip/Postal Code:*

Phone*:

Credit Card Information

Card Holder Name:*

Credit Card Number:*

Credit Card Type:

Credit Card Expiration:

Billing Information

Please check this box if your credit card information is the same as your contact information.
If not, please fill out the information below:

Address 1:*

Address 2:

City:*

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Province:

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Country: