Please fax this form to 613.236.0743

PLEDGE ONLINEPledge online at:

https://ota.com/canada-ota/support-cota/

QUESTIONS?Contact:

Ann Fisbein

Canada Organic Trade Association

1145 Carling Avenue, Suite 7519

Ottawa, ON K1Z 7K4

613-482-1717

a�sbein@ota.com

COTA 2016 investments are not charitable

contributions, but may be tax deductible

as regular business expenses.

COTA 2016 ANNUAL FUND INVESTOR PLEDGE FORM

YES! We will support the Canada Organic Trade Association’s

government relations, consumer education and media outreach

initiatives in 2016 by making an investment of:

$25,999 Leadership Circle

$17,999 Major Donor

$11,999 Crown Benefactor

$7,999 Gold Benefactor

$5,999 Benefactor

$3,999 Patron

$2,999 Sponsor

$1,999 Contributor

$799 Champion

$599 Friend

$399 Donor

$ _______ Supporter

METHOD OF PAYMENTFull Payment Enclosed

(payable to Canada Organic Trade Association, 1145 Carling Ave, Suite 7519, Ottawa, ON, K1Z 7K4)

Charge the Full Amount to my Credit Card (VISA or MasterCard)

Card # _________________________________________________ Exp. Date _____________

Cardholder Name ___________________________________ Billing Postal Code ___________

Cardholder Signature ___________________________________________________________

Bill Me. Upon invoice from COTA, I agree to make the following payments toward this total pledge:

One full payment (due within 30 days)

Other (please specify) _____________________________________________________

Authorized Signature __________________________________________________________

INVESTOR INFORMATIONCompany Name: _______________________________________________________________

Company Name (for acknowledgment): ____________________________________________

Contact Person: _______________________________________________________________

Title: ________________________________________________________________________

Address: _____________________________________________________________________

City: _________________________________ Province: ___________ Postal Cod e: _________

Tel: _______________________________________________ Fax: _______________________

E-mail: _______________________________________ Website: _______________________

TOTAL PAYMENT: $___________

COTA 2016 ANNUAL FUND INVESTOR LEVELS AND RECOGNITION

LEADERSHIP CIRCLE $25,999· Exclusive Quarterly Executive Briefings · Inclusion of your company’s products in OTA’s desk-side media briefing tour· Leadership Circle press release sent to industry trade publications and media · Priority opportunities for your company in OTA consumer marketing projects

throughout 2016· One-time complimentary 1/4 page ad in hardcopy edition of The Organic Report and

additional ongoing 20% o hroughout the year· Thank you listing with logo and link on the COTA/OTA website and prominent listing

in The Organic Report and alive Magazine

· Recognition with company logo published in Certified Organic, Natural Foods Merchandiser, and Taste for Life the Retail Approach

· Complimentary copy of the 2015 Organic Industry Survey Executive Summary· Recognition plaque

MAJOR DONOR $17,999· Quarterly Executive Briefings· Thank you listing with logo in The Organic Report, alive Magazine and link on COTA/OTA website· Recognition with company logo published in Certified Organic, Natural Foods Merchandiser, and Taste for Life the Retail Approach

· 20% on display advertising in The Organic Report· Recognition plaque

CROWN BENEFACTOR $11,999· Quarterly Executive Briefings· Thank you listing with logo in The Organic Report, alive Magazine and link on COTA/OTA website· Recognition with company logo published in Certified Organic, Natural Foods Merchandiser,

and Taste for Life the Retail Approach· 20% on display advertising in The Organic Report· Recognition plaque

GOLD BENEFACTOR $7,999· Thank you listing with logo in The Organic Report, alive Magazine and link on COTA/OTA website· Recognition with company logo published in Certified Organic, Natural Foods Merchandiser, and Taste for Life the Retail Approach

· 15% on display advertising in The Organic Report· Recognition plaque

BENEFACTOR $5,999· Thank you listing in The Organic Report, alive Magazine and link on COTA/OTA website· 15% on display advertising in The Organic Report· Recognition plaque

PATRON $3,999· Thank you listing in The Organic Report, alive Magazine and link on COTA/OTA website

SPONSOR $2,999 CONTRIBUTOR $1,999CHAMPION $799FRIEND $599DONOR $399

· Thank you listing in The Organic Report and link on COTA/OTA website