Community Sponsor Form | Black Music Therapy Network, Inc.

Community Sponsor Submission Form

Thank you for your interest in Black Music Therapy Network, Inc. Becoming a sponsor instantly provides opportunities to deepen connections with people at the intersection of music and health within Black communities. Supporting is easy! Complete the sponsorship form below, select your plan, and support today!

First Name

Last Name

Preferred Name

Pronouns

Name of Requesting Individual, Business, or Organization (please include primary contact)

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Phone

Please briefly share your organization’s values and how they relate to BMTN’s mission. This information may be used on our website under our sponsorship list, acknowledging you as a university sponsor.

If there is any additional information you would like us to know, please share here:

Do you want to be included in our public sponsorship list? If so, please enter your name, business, or organization, and contact info as you would like them to appear on the website (e.g. Unsung, LLC; lisa@unsungllc.org).

By submitting this form, I affirm that:

I am a representative of the entity listed in this form.

I affirm the mission of the BMTN to support the health and well-being of Black communities through music.

Enter the amount you wish to pay: