Supporter Drive

First Name *

Last Name

Email Address *

Phone *

Supporter Levels *Platinum [ $150 ]Red [ $100 ]Blue [ $50 ]White [ $25 ]

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Red Gift

The Red Level includes: one decal; the supporter’s name on our web site; and a pair of 16 oz. Tervis tumblers with NH Legends of Hockey logo.

Blue Gift

The Blue Level Includes: one decal; the supporter’s name on our web site; a baseball hat with Velcro closure and NH Legends of Hockey logo.

White Gift

The White Level Includes: one decal and the supporter’s name on our web site.

Platinum Level Gift

Please enter the information below to receive your Port Authority Men's 0r Women's Vest.

Please Select *MensWomensPlease choose if your order a Men's or Women's Vest.

Color *BlackBattleship GreyNavyBlack Charcoal

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country

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Donation Amount

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Fees

Total

$

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