Sponsorship Upgrade – ASRC @ Clifford Beers

Sponsorship UpgradePaula Pierce2020-12-27T13:29:27-05:00

Upgrade Your Sponsorship

Name*
First Last
Email*
Phone*
Website*
Current Tier*
Please select the support tier you are upgrading from.
Upgrade To*
Please select the support tier you wish to upgrade to.
Upgrade To*
Please select the support tier you wish to upgrade to.
Upgrade To*
Please select the support tier you wish to upgrade to.
Upgrade To*
Please select the support tier you wish to upgrade to.
Upgrade To*
Please select the support tier you wish to upgrade to.
Upgrade To*
Please select the support tier you wish to upgrade to.
Upgrade To*
Please select the support tier you wish to upgrade to.
Advertisement (Only Gold+, Platinum+, Signature+)
Max. file size: 256 MB.
Please upload the image file you would like us to use for your sponsorship. For platinum please provide a 1150x175 pixel image.
Payment Type (Check Preferred; Or, Credit Card: Fees Will Be Added If Used)*
Processing Fee*
Price: $0.00
In order to pay for this upgrade by credit card you must agree to pay the 5% credit card processing fee. If you instead opt to send us a check you can avoid paying this fee.
Processing Feeb*
Price: $0.00
In order to pay for this upgrade by credit card you must agree to pay the 5% credit card processing fee. If you instead opt to send us a check you can avoid paying this fee.
Processing Feec*
Price: $0.00
In order to pay for this upgrade by credit card you must agree to pay the 5% credit card processing fee. If you instead opt to send us a check you can avoid paying this fee.
Processing Feed*
Price: $0.00
In order to pay for this upgrade by credit card you must agree to pay the 5% credit card processing fee. If you instead opt to send us a check you can avoid paying this fee.
Processing Feee*
Price: $0.00
In order to pay for this upgrade by credit card you must agree to pay the 5% credit card processing fee. If you instead opt to send us a check you can avoid paying this fee.
Processing Feef*
Price: $0.00
In order to pay for this upgrade by credit card you must agree to pay the 5% credit card processing fee. If you instead opt to send us a check you can avoid paying this fee.
Processing Feeg*
Price: $0.00
In order to pay for this upgrade by credit card you must agree to pay the 5% credit card processing fee. If you instead opt to send us a check you can avoid paying this fee.
Total
$0.00
Please mail a check payable to Autism Services & Resources Connecticut, Inc. to:

101 N. Plains Industrial Road
Wallingford, CT 06492
Credit Card
Card Details
Cardholder Name
Billing Address*
Street Address City State ZIP Code
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