PLEASE PRINT AND RETURN THIS FORM OR CLICK ON LINK

ALONG WITH YOUR CAMERA-READY BUSINESS CARD OR PRINTED IN ‘HONOR OF’ LINE

 BY FRIDAY, October 2, 2009 (No date exceptions)

 

 

NAME OF COMPANY/PERSON/FAMILY:  _________________________________________________________

 

ADDRESS:  ______________________________________________________

 

CITY:  ______________________________STATE: ______________________ZIP:______________________

 

TELEPHONE:  __________________________ 

 

 

AD SIZE:  All Ads must be camera ready (correct size)

               

                ______   Full Page Ad (5x7)              $100.00                

 

_______  ½ Page Ad ( 5 X 31/2 )      $50.00

 

                _______ Business Card      $25.00

 

                _______  In Honor of/Remembrance :  (name only, past or present)  $10.00 per name     

 

PLEASE PRINT CLEARLY:

                                                __________________________________________________________

 

                                                __________________________________________________________

               

                                                __________________________________________________________

 

AMOUNT ENCLOSED:__________________________________ 

 

Please make checks payable to:  "Standing for a Cure"

And mail to:             Dale Gudejko

                                42 James St

                                Framingham, MA 01701

 

 

PLEASE BE SURE TO ATTACH YOUR AD OR BUSINESS CARD

 

 Questions, call Dale Gudejko, 508-259-7636 or bbabesfundraiser@gmail.com

 All proceeds will be supporting both "Hope in  Bloom" (www.hopeinbloom.org) and the New Vernon Cancer

at Newton Wellesley Hospital in partnership with the Mass General Hospital that opened in September 2009. (www.nwh.org/cancer).

 

 

Total Enclosed: _________________________________________ Received by:_____________________________