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TNT DONOR FORM Powered By Docstoc
					                                                                                             MY PLEDGE TO YOU
              TNT DONOR FORM
                                                                       I have joined a very special Team In Training (TNT) program of
                                                                       more than 35,000 volunteers nationwide. We will run, walk,
                                                                       cycle or swim in established marathons, half marathons, century
                                                                       rides or triathlons for a reason much more important than the
                                                                       personal challenge. As members of TNT, we participate in these
                                                                       events on behalf of local patients and will raise funds to battle
                                                                       leukemia, Hodgkin and non-Hodgkin lymphoma and myeloma.

                                                                       Over 110,960 people in the United States will be diagnosed with
                                                                       a blood cancer this year – an estimated 55,100 people will die.
                                                                       Although the cause of these cancers remains unknown, steady
                                                                       advances in research and treatment are bringing us closer to
                                                                       cures. In fact, thanks to research funded in part by The
                                                                       Leukemia & Lymphoma Society, the survival rate for the most
Yes! I will help fight leukemia, Hodgkin and non-Hodgkin
lymphoma, and myeloma in recognition of the efforts of:                common form of childhood leukemia has improved from 4% in
                                                                       1960 to 85% in 2000.

                                                                            ABOUT THE LEUKEMIA & LYMPHOMA SOCIETY
Team In Training Member                                                The Leukemia & Lymphoma Society is the world’s largest
                                                                       voluntary health organization dedicated to funding blood cancer
                New York City Triathlon                                research, education and patient services. We offer a wide
 ________________________________________________________              variety of programs and services in support of our mission to
Team/Event                                                             cure leukemia, lymphoma, Hodgkin's disease and myeloma, and
                                                                       to improve the quality of life of patients and their families. The
I select to donate (please circle):                                    Society is a nonprofit organization that relies on the generosity of
                     $50               $200                            individual and corporate contributions to advance its mission.
                     $100              $250
                     $150              $500                                             WHY WE NEED YOUR HELP
                OR                                                     Until there is cure, we need the support of people like you!
I would like to make a total donation of: $ ____________               Funding for research is imperative in helping the Society find
                                                                       cures for leukemia, Hodgkin and non-Hodgkin lymphoma and
 Check Enclosed Make check payable to The Leukemia & Lymphoma         myeloma. Over the years, leukemia research has proven to be
Society                                                                the window of hope for potential cures for other forms of cancer.
                                                                       Bone marrow transplants as well as chemotherapy – the
 Credit Card Donation          Please circle one: (AMEX, MC, VISA)    backbone for treatment of most forms of cancer – stem from
                                                                       leukemia research.

                                                                           PLEASE FORWARD YOUR CONTRIBUTION TO THE
Credit card #: ___________________________________________________           PARTICIPANT THAT YOU ARE SUPPORTING
Expiration Date: _________________________________________________
                                                                             *** FOR MORE INFORMATION CONTACT ***
Card holder: ____________________________________________________
                                                                                      The Leukemia & Lymphoma Society
Name (if different): _______________________________________________                        New York City Chapter
Signature: ______________________________________________________                      Phone (212) 448-9206 ext. 234
Address: _______________________________________________________
                                                                       In accordance with the Internal Revenue Code, the amount you
City: ___________________ State: _______________ Zip: __________                      donate is 100% tax deductible.
Phone: _________________________________________________________

Email: _________________________________________________________

 My company will match this contribution (matching gift
form is attached).

 Please send me information on the Team In Training

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