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1999 Season

sponsor form
print me out and mail me
YES! I want to contribute to the Leukemia Society and be a part of Erin's team.

(Please select the appropriate contribution below)

_______    $26.20 "A buck a mile, not too bad"

_______    $50.00 "I think you can, I think you can..."

_______     $75.00 "You go girl!"

_______     $100.00 "Wow!! The sun really has gone to your head!"

_______     $200.00 "You owe me..."

_______    $500.00 "You owe me big..."

_______    $3000.00 "I just made a killing in the stock market and am trying to avoid capital gains tax!"

_______    $ Create your own

Please make your checks payable to the Leukemia Society of America and mail it back to me by October 1st. If that isn't possible, I will gladly accept your donation (and support) after that date.

Erin Malone
107 S. Mary Ave. #135
Sunnyvale, CA 94086

Don't forget to keep checking the website and follow my progress. http://www.emdezine.com/TeamInTraining

Your contribution is 100% tax deductible.
( ) Check if you would like to receive a receipt for your tax deductible donation.

Name: ___________________________________

Address: ________________________________

City/State/Zip: _________________________

email: __________________________________

If you would like to charge your contribution to your credit card:

MC/VISA (circle one) #:________________________

Name on card: _________________________________

Expiration date: ______________________________

Signature: ____________________________________