Pay By Check Become a 2023 Patriot Partner (Pay by Check) Company / Organization InformationCompany / Organization Name* Contact Name* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email PhonePartnership Level Partnership Levels are: Platinum ($2,500-4,999) Diamond ($5,000-7,499) Patriot ($7,500+) Please mail check to NGAMS Patriot Partnership Program Attn: Greg Taylor PO Box 627 Jackson, MS 39205Your logo, website and contact informationYour logo and other information will be included on our website in your partner listing.Your LogoPlease attach a logo that we can include on our website. Allowed file types: JPEG, PNG, EPS, PDF, or Adobe IllustratorAccepted file types: jpg, jpeg, png, eps, ai, pdf, Max. file size: 5 MB.Your Website Address Your Contact InformationPlease include the contact information that you would like included on our website in your partner listing.
