The Touro Infirmary Foundation

AMPed Fest Community Partner Application

Space is limited for Community Partner tents. There is no fee as a Community Partner. Organizations that qualify for space will be notified by an AMPed Fest member as soon as possible. All materials for Community Partners will need to be provided by the community partner. AMPed Fest will not provide any materials.

  • Please enter your first name.
  • Please enter the applicant's name.
  • Please enter your business' address.
  • Please enter your business' city.
  • Please enter your business' state.
  • Please enter your business' zip code.
  • Please enter your business' website address.
  • This isn't a valid phone number.
    Please enter your phone number.
  • This isn't a valid phone number.
    Please enter your phone number.
  • This isn't a valid email address.
    Please enter your email address.
    Please make a selection.
  • Please enter your total amount.
  • Billing Information
  • Please make a selection.
  • Please enter name on card.
  • Please enter your card number.
  • Please enter card billing address.
  • Please enter card billing city.
  • Please select an option.
  • Please enter card billing zipcode.
  • Please enter your card expiration date.
  • Please enter your card verification number.
  • Sponsored Person Details
  • Please enter the sponsored individual's first name.
  • Please enter the sponsored individual's last name.
  • Please enter the sponsored individual's address.
  • Please enter the individual's city.
  • Please enter the individual's state.
  • Please enter the individual's zip code.
  • This isn't a valid phone number.
    Please enter a phone number.
  • This isn't a valid email address.
    Please enter an email address.