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Partnership Commitment Form

FOR THE SAFETY OF ALL PARTICIPANTS INCLUDING PATIENTS & THEIR FAMILIES, SPONSOR ACKNOWLEDGES AND AGREES THAT LLS MAY MODIFY THEIR ACTIVATION & BENEFITS FOR IN-PERSON EVENTS OR CONDUCT THE ACTIVATION VIRTUALLY. TO CONFIRM YOUR SPONSORSHIP, PLEASE COMPLETE THIS FORM & SUBMIT FOLLOWING THE DIRECTIONS BELOW.

PARTNERSHIP LEVELS

• Presenting Partner $75,000
• Platinum Partner $40,000
• Gold Partner $25,000
• Silver Partner $15,000
• Bronze Partner $10,000

MAKE A DONATION

• I would like to make a fully tax-deductible donation to The Leukemia & Lymphoma Society through the Student Visionaries of the Year campaign in the amount of $____________.

Candidate Team to Support:_______________________________________________________________________

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Desired Partnership Experience: ___________________________________________________________________

• I am unsure at this time.  Please contact me to discuss partnership activations. 

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Sponsor Name:  _______________________________________________________________________________

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Contact Name & Title: ___________________________________________________________________________

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Email: ________________________________________________ Phone:_________________________________

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Address: ______________________________________________City: _____________ State: ___Zip:___________

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Donor Signature: _____________________________________________   Date____________ 

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Billing Department Contact and Email Address: ________________________________________________________

PARTNERSHIP CONTACT INFORMATION

Please Mail All Checks 

And a copy of this form to:

LLS

P.O. Box 22470

New York, NY 10087-2470

Please return this completed form to

The Leukemia & Lymphoma Society - Cleveland

Email: tiffany.ziegler@lls.org or savannah.drdek@lls.org 

All funds are due by 

June 10^th, 2025

in order to count towards a candidate team’s campaign total

Certain activations are subject to availability.

• Prior to the start of the 7-week campaign, January 17th this form can be submitted to the candidate team that you are supporting. They will submit to LLS on the day candidate fundraising begins.
• Beginning at 12:01am on Friday January 17^th this form can be submitted to LLS via email.
• Once LLS has accepted the form or the funds, sponsors would begin to be eligible for sponsor benefits.

This Agreement is effective from the date signed until the payment obligation(s) set forth above are made.  Sponsor grants LLS a limited, royalty- free, non-exclusive license to use Sponsor’s name, trademarks, logos and copyrights (“Marks”) solely in connection with this Agreement.  Sponsor shall hold LLS’s confidential and proprietary information in confidence and ensure that it is not disclosed to any third party.  Sponsor agrees to indemnify and hold harmless LLS, its employees, successors, and assigns from all claims and liabilities of every kind incurred by LLS’s use of Sponsor’s Marks or a breach of this agreement by Sponsor. Sponsor will comply with all laws and agrees that its Marks do not infringe the rights of any other person. Sponsor will not assign, transfer  or sub-license this Agreement without LLS’s prior written approval.​

• Please Invoice Us

• Mission Card Sponsor $7,500
• SVOY Pride Sponsor $5,000
• Candidate Supporter $3,500

MSA 1-25

MSA 1-25

All sponsorships of $24,999+ will be required to sign a Letter of Agreement (LOA).