Help Raise Funds for Autism
Join Team Rebecca and Walk, Bike or Run for Kids
Thank you for your interest in participating on
your own, or forming a team to collect pledges for each mile that you Walk,
Bike or Run for Autism.
Rebecca walked 1,000 miles from Thanksgiving 2003 to
2004. You
don’t have to go 1000 Miles - Just
get out there and do what you can. Set a
personal goal for any number of miles or form a team and set a team goal.
·
Teams raising $500 or more
receive Drive For Rebecca t-shirts*
·
Teams raising $250 to $500
receive Drive for Rebecca Frisbees
·
Teams raising $100 to $200
receive Drive for Rebecca patches
*If
your team raises $500+, please include team member shirt sizes when mailing
this form with checks.
*A
maximum of ten of each item listed above will be provided for teams raising
$100, $250 or $500.
PLEASE PRINT THIS FORM to ask for pledges from friends, family
members and co-workers.
Goal (number of miles)__________ Target Date to Finish:__________
Name Address Email $ Per Mile Total
Examples using 1000 miles
John
Smith 123 Jones Rd.
Anytown,
________________________________________________________________________________________________
Joan
Smith 123 Jones Rd.
Anytown,
________________________________________________________________________________________________
1)
________________________________________________________________________________________________
2)
________________________________________________________________________________________________
3)
________________________________________________________________________________________________
4)
________________________________________________________________________________________________
5)
________________________________________________________________________________________________
6)
________________________________________________________________________________________________
7)
________________________________________________________________________________________________
8)
________________________________________________________________________________________________
9)
________________________________________________________________________________________________
10)
________________________________________________________________________________________________
Please
make checks payable to:
THE DRIVE FOR REBECCA
(or to make a credit card pledge, click on
“PayPal Donate” at www.DriveForRebecca.org).
And
mail checks to:
Please
include the following when you mail your checks:
Name:____________________Team
Name(if you are part of a team)_____________________
Address:________________________________________________________________________
City, State,
Zip:__________________________________________________________________
Phone:______________________________Email
address:_______________________________
The Drive
for Rebecca, Inc. is a 501(c)3 non-profit organization. Donations are tax
deductible to the extent allowed by law.
For
more information on this organization please contact your state's governmental
charitable registration unit or The Drive for Rebecca, Inc. ("The
Drive")
at
201-567-3699 or http://www.DriveForRebecca.org.
If your state's governmental charitable registration unit does not have
any information regarding
The
Drive, please contact The Drive directly, so it may provide your state's
governmental charitable registration unit with any required information.
The Drive for Rebecca
Building better lives for children
with autism™
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The Drive for Rebecca, Inc.
