Little Victors Wagon Program

WAGON NAMING COMMITMENT FORM


NAME*
ADDRESS*
DONATION - I would like to name a Little Victors Wagon at the following level:*

A portion of each naming gift ($250) will provide maintenance for wagons.

Please note:

  • A limited number of wagons are available.
  • One wagon will be named per gift or donor, per year. Wagons are named for one year.
  • Based on inventory, named wagons may be new or gently used.
DONATION DESIGNATION*

LICENSE PLATE

A license plate acknowledging your contribution will be attached to the back of each wagon. Donors will receive a duplicate copy of the license plate.

100 character limit, including spaces.

Please note:

  • Graphics like sponsor logos can be included with permission at the $4,000 and $5,000 levels, but personal photos cannot be added. Vector files required (.svg, .eps, .ai).
  • We reserve the right to change/edit plate language for any existing or former wagon.
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WAGON RELEASE - Once you have sponsored a wagon, join us at C.S. Mott Children's Hospital to celebrate its release into the fleet!*

Please note:

Wagon releases occur approximately four weeks after donation receipt and plate approval. Once a wagon is released, it is a piece of medical equipment at Mott. Requests to locate a wagon cannot be accommodated.