Westerville South Instrumental Music Boosters Walk-A-Thon Sunday May 17, 2009 Time: 2:00-6:00 Name: Email: Phone Number: Street Address City/Zip: I am a family member of_______________________________ (Marching Band Student). I am 2009 Senior. I am donating my contributions to ____________________ (Marching Band Student). I plan to walk at least 5 kilometers (3.1 miles). Dear Friend, I am participating in the Westerville South Instrumental Music Booster Walk-A-Thon. All proceeds will help fund individual band members individual band costs and to support the efforts of the music boosters. You can sponsor me for a pledge amount. We hope that you will make your contribution before the walk -a-thon. Make checks to Westerville South Instrumental Music Boosters or WSIMB. All contributions are tax- deductible. Thank you! Total Amount Name of Sponsor Pledge Collected Amount from Sponsor 1 2 3 4 5 6 7 8 9 Total Amount Name of Sponsor Pledge Collected Amount from Sponsor 10 11 12 13 14 15 16 17 18 19 20 21 Page Two Total Page One Total Total Donations Participants: The Westerville South Instrumental Music Boosters Goal is for each participant to raises at least $50 in contributions. Please bring this form with you to the Walk-A-Thon on April 25, 2009.
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