Purchase Advertisement

Fields marked * require an entry.

Package Name	Amount	Subtotal

Back Outside Cover - 5.5 W x 8.5 H	$7,500.00	$0.00



Inside Cover (Front or Back) - 5.5 W x 8.5 H	$6,500.00	$0.00



Double Full-Page - 4.5 W x 8 H (each page)	$5,000.00	$0.00



Full-Page - 4.5 W x 8 H	$2,500.00	$0.00



Half-Page - 4.5 W x 3.75 H	$1,250.00	$0.00



Quarter-Page - 2.125 W x 3.75 H	$750.00	$0.00

Yes, I'd also like to make a Fund a Cure donation.

Amount:

Total:

$0.00

As a convenience, you may pre-register a credit card on the submission page to charge your purchases at event 2018 Promise Ball.

I authorize Breakthrough T1D - Greater CT and Western Mass Chapter - 4090 to use the credit card entered on the submission page at event 2018 Promise Ball. Once the transaction has completed successfully, a confirmation receipt will be sent to the email address entered.

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