Testing: Sponsorship Form

Sponsor First Name *

Sponsor Middle Name

Sponsor Last Name *

GenderMaleFemaleOthers

Select Benefactors Choice of Hotel

Select Donors Choice of Hotel

Select Premium Donors Choice of Hotel

Choose Preffered DaysPlease choose option for which days of the event you would need the HotelJuly 2nd - July 4thJuly 3rd - July 5thJuly 2nd-July 5th

Select Bronze Sponsors Choice of Hotel

Select Silver Sponsors Choice of Hotel

Select Gold Sponsors Choice of Hotel

Select Platinum Sponsors Choice of Hotel

Select Diamond Sponsors Choice of Hotel

Select Grand Sponsors Choice of Hotel

Select Title Sponsors Choice of Hotel

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country *

Email Address *

Phone

Additional AttendeePlease add names of additional attendees

First Name

Middle Name

Last Name

GenderMaleFemaleOthers

Payment OptionsCredit/Debit CardBank TransferZelleCheck

Sponsorship amount to be paid (USD)

Credit / Debit Card *

Transfer to be sent at the following bank

Bank Name: Chase Bank

A/c Number: 3882520077

Routing Number: 021000021

Name of account holder

Amount (USD)

Bank name

Routing Number

Confirmation number of transfer

Pay By Zelle

NABC Zelle Email : cabnorthamerica@gmail.com

Name on Zelle Account

Zelle Account

Zelle confirmation number of Transfer

Pay By Check

A Drawn to …………………Either of 3 below
1. Cultural Association of Bengal,
2. CAB
3. NABC
·Check to be sent at : Address ; 20 Cambridge road, Lafayette, New Jersey - 07848

Bank name

Name of account holder

Check amount (USD )

Bank account number

Bank Routing number

Check number

Note

The registration number of the attendees will be cancelled in case of any payment dispute, non processing of the payment, lack of conformity, bounce of check, withdrawal of the payment and due to noncleared payment instrument.

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North American Bengali Conference