EPIC Sponsorship Registration
Thank you for your sponsorship. We can't do it without your support.
Sign in to Google to save your progress. Learn more
Sponsorship Level *
If Event or Program sponsor, please indicate amount and event:
If individual member sponsor, please indicate name of member:
Business Name: *
Mailing Address: *
Email Address: *
Phone Number: *
Business Social Media - Please indicate Facebook, Instagram, Twitter or other:
Business Website:
E-Signature - Please Type your Name as verification: *
Payment Options:
Online
If wanting to pay online, please select the "Make a Payment" button underneath sponsorships on the website.
 
Over-the-Phone
Payments can also be made over the phone by credit card or by check at 740-702-2722. 

Mail
Checks may be made payable to EPIC and dropped off or mailed to EPIC c/o Chillicothe-Ross Chamber of Commerce, 45 E. Main St., Chillicothe, Ohio 45601. 

Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of EPIC.

Does this form look suspicious? Report

Google Forms