Sponsor Form
In support of LSA and your efforts, I am enclosing my tax deductible
contribution.
Suggested contribution amounts:
$10.00
That’s enough - we hardly even know her.
$15.00
I have to live/work with her.
$26.20
She can do 26.2 miles!
$50.00
Way to go.
$100.00
I would like an autographed picture of this couch-potato
turned marathoner crossing the finish line.
$250
Wow!! That’s incredible!!
$ ____
Donations of ANY amount are greatly appreciated.
Please make check payable to: The Leukemia Society of
America, Inc.
Name:
Address:
City, State, Zip:
Mastercard / Visa (circle one) Expiration date:
Card #
Name as it appears on card:
Signature:
Please return this form and your check to me by March 20, 1998. If that
is not possible I will gladly accept donations after that time.
THANK YOU!!!