Form

You have taken the first step in reaching out to your community. We are thankful for your patronage, and together we can positively affect many individuals. Please take a few moments to work out the details of your pledge, and we can start rolling with the programs to enhance lives in the community.

First Name*

Last Name*

Company

Address*

City*

State*

Postal Code*

Country*

Email*

Day Phone*

Evening Phone

		Program Sponsor	$15,000.00
		One Day Event Sponsor	$5,000.00
		Sponsor a Volunteer	$2,500.00
		Sponsor a Veteran	$1,000.00
		Item Donation

Please note exactly how you would like your company or organization listed on social media/banner/etc or in silent auction. Please also describe what you are donating if you have chosen 'item donation'.

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		PayPal We will email you a PayPal Invoice.
		Wire Transfer We will contact you by phone to complete.
		Check or Money Order Mail to: AQUANAUTS ADAPTIVE AQUATICS, 801 NE 33 Street, Fort Lauderdale, FL 33334
		In Person (South Florida) We will contact you by phone to arrange.

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