Walk For Autism Registration

"*" indicates required fields

Name*

First Last

Email*

I would like to Register as:*

Sponsor

Vendor

Resource Provider

Individual ($10 per person)

Team ($10 per person)

Individual on the Autism Spectrum (free)

Children under 10 (free)

Sponsor Level

Bronze $500 (1/4 page ad in booklet, logo on all printed materials, social media and event brochures. Table under the tent included.

Silver $1,000 Bronze $500 (1/2 page ad in booklet, logo on all printed materials, social media and event brochures as well as t-shirts given to all Walk participants.. Table under the tent included.

Gold $5,000 Bronze $500 (FULL page ad in booklet, logo on all printed materials, signage at walk site and ADS website, social media and event brochures as well as t-shirts and bags given to all Walk participants.. Table under the tent included.

Team Name (if applicable)

Number of Team Members (approximate ok)

Organization (if applicable)

Address

Street Address Address Line 2 City State ZIP Code

Phone

Would you like to reserve a table space at the event?

Yes

Maybe

If yes, choose below

I would like a space under one of the big tents with a table and two chairs ($50)

I would like a space under one of the big tents, I will bring my own table and chairs ($35)

I will bring my own pop up tent with a table and chairs ($25)

Table included in Sponsor Level (N/C)

Reservation Payment*

I will complete registration payment via Paypal after submission

I will pay by credit card - go to www.adshelps.org and click "Donate" to use credit card

I will mail my reservation payment to Autism Directory Service, Inc P.O. Box 73 Wappingers Falls, NY 12590

I will pay at the registration table the day of the Walk - this option is for Walkers only

Additional Information or Questions

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