Forbidden Art Panel Sponsorship

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Forbidden Art Panel Sponsorship

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Please correct the field(s) marked in red below:

1
Name of individual or company providing funds:
 *
2

Complete address of entity providing funds:
(Include Street, City, State, Zip)

 *
3
Amount of funds provided ($150 minimum)
 *
4

Name of sponsor as it should appear in recognition of sponsors.  Maximum 36 characters, please.
Examples: "Mr. & Mrs. John Doe" or "Allan Furniture Corporation"

 *

Please mail check payable to City of Wixom to:

City of Wixom
Attn: Debra Barker
49045 Pontiac Trail
Wixom, MI 48393

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