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SPONSOR FORM
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All contributions are 100%
tax deductible!
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Multiple donations are heartily encouraged, so please
tell your friends!
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If your company MATCHES YOUR DONATIONS or gives
corporate donations, that additional support would be greatly appreciated
and can be included with your contribution below.
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My contribution
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PLEASE CIRCLE YOUR CHOICE
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My company's contribution
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$25.00
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Because I'm healthy
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$150.00
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$50.00
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For the ones I love
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$250.00
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$75.00 |
Wildflowers for everyone!
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$500.00
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$100.00
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Good Karma
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$750.00
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$200.00
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For Ben
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$1,000.00
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$500.00
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GO GIRL GO!
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$1,000.00
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Following my heart
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$
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I want to make up my own amount!
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$
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WooHoo! My company is matching my donation!
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$
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OK, now tell us about
you!
The Leukemia and Lymphoma Society needs this information in order to confirm your donation and provide you with a written receipt for tax purposes. |
| Name | |||||
| Address | |||||
| City | State | Zip | |||
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Please make checks payable to The
Leukemia and Lymphoma Society of America, and send in by
March 15, 2001. If you miss this deadline,
fear not. Your money is good here any time!
mail to: Stephanie D. Anderson, 14 Maureen Court, Pleasant Hill, CA 94523 |
| To charge your contribution to a credit card, please complete the following* |
| Name on card | |||
| Visa/MC (circle one) | Card # | EXP. | |
| Signature | |||
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*This sheet will be forwarded directly to the Leukemia
Society's accounting agency
THANK YOU!! |