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2019 Minnesota Night Reception Sponsorship Form
December 9, 2019
6:00 – 8:00 PM
Mandalay Bay Resort and Casino – South Pacific Ballroom AB
Las Vegas, Nevada 89119
We wish to sponsor the 2019 Minnesota Night Reception.
Company Name: Website:
Contact Person: Title:
Address:
City/State/Zip:
Telephone:
Email:
Payment Options (select one):
$500 $750 $1,000
Check
Please make check payable to MSHP and submit to:
MSHP ● 13911 Ridgedale Drive, Suite 260 ● Minnetonka, MN 55305
Credit Card
Visa MasterCard
Name on credit card:
Billing Address:
Credit Card Number: CVV#:
Expiration Date:
Signature: Date:
Submit form to fax number: 952-541-9684 or email to mpeterson@ (Please do not include credit card information if sending an email – call the MSHP office)
Questions call MSHP office: 952-541-9499
MSHP Tax ID#: 41-1401022
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