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The Board of Directors and members of the Genetic Toxicology Association (GTA) are inviting organizations to support the GTA’s efforts to foster sustained excellence in genetic toxicology. The GTA is a tax-exempt educational and scientific organization and any contributions will be used to help the GTA continue to support its activities to promote scientific excellence in this field. Two contribution mechanisms are available: Sustaining Membership (Gold: $500 or Silver: $250) for general, non-designated use by the GTA and a Targeted Contribution towards a specific event or function (e.g., meeting breaks or lunch, offsetting meeting expenses, student travel award, etc.). Please fill out form below to sponsor online through PayPal using your PayPal account or a credit card (you do not need a PayPal account to do this).

SPONSORSHIP RUNS FROM JANUARY 1, 2017 through DECEMBER 31, 2017

2017 Sponsorship Levels
Check appropriate box to become a either a Gold or Silver Sponsor:

Gold Level - $500.00
Silver Level - $250.00
Please send your Company logo to The GTA Webmaster
(specifications: jpg, no wider than 189 pixels)
Company Name
Address
Address2
City State Zip
Country
 
Company Representative Name
Email
Daytime Phone Fax
 
If you are renewing your Sponsorship, has any information changed from the previously submitted information?  Yes       No
 
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Please note that information marked in red above is required before the system will
accept your form. Refer any questions about GTA Sponsorship to Leon Stankowski: lstankowski@gta-us.org or 570-510-6397.
Refer any technical questions about this form to The GTA Webmaster.

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