Participant's Name, Phone
ADDRESS: Street, City, State, Zp code

THANK YOU FOR YOUR DONATIONS TO THE 2012 "AIDS AND CANCER LEARN-TO-DANCE-ATHON"
(DATE AND TIME TO-BE-ANNOUNCED) TO TAKE PLACE AT DANCESPORT DUPONT CIRCLE,
The Church of the Pilgrims Fellowship Hall, 2201 P St. NW, Washington DC 20037 (1520 22nd St. NW on google maps)
"Any" amount raised will be greatly appreciated by the AIDS and cancer victims and their families. Ask each donor to indicate which charity(s) they would like their donations to benefit. Write checks to "(receiving 501c3 to-be-determined since Lambda DanceSport DC does not yet have a 501c3 designation)" or directly to the designated charity. All undesignated funds will be divided equally between 6 designated organizations to-be-determined. Funds may also be made directly to any other favorite charities, if desired by the donor/sponsor.
All Contributions are 100% Tax-deductible and 100% of all funds will go directly to the specified charity(s) to-be-determined similarly as in 2004: (1) Whitman-Walker Clinic, (2) The Mautner Project, (3) The Susan G. Komen Breast Cancer Foundation, (4) The National colorectal Research Alliance, (5) St Jude Children's Research Hospital and (6) Oprah's Angel Network. Please print legibly.... and Thanks!!

 SPONSOR'S NAME COMPLETE ADDRESS (EMAIL, ST., APT. NUMBER , CITY, STATE) ZIP CODE AREA CODE & PHONE
AMOUNT PRE-PAID & CHARITY (S)
1.        
   2.        
   3.        
   4.        
   5.        
   6.        
   7.        
   8.        
   9.        
   10.        
   11.        
   12.        
   13.        
   14.        

Please bring this form to the 2012 "AIDS and Cancer Learn-To-Dance-Athon", along with all pledges to DanceSport Dupont Circle, The Church of the Pilgrims Fellowship Hall, 2201 P St. NW, Washington DC 20037 (1520 22nd St. NW on google maps). For Additional information or to volunteer for this event, please contact: Terry Chasteen, 202-462-0870, 202-596-4860 (cell), TerryChasteen@yahoo.com, info@LambdaDanceSportDC.org, www.PleaseDanceWithMe.com, www.DanceSportDupont.com, www.LearnToDanceAthon.org
Sponsored by Lambda DanceSport DC, The Church of the Pilgrims, DanceSport at Dupont Circle and www.PleaseDanceWithMe.com.