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Please use this form for your collections. You may download the form via this link. A sample of the form is included below.


SAMPLE FORM

  WALK FOR AUTISM 2010

SATURDAY, April 17TH

HAMPTON PARK

30 Mary Murray Drive, Charleston, S.C.

Registration/ Check-in 9:00 am    w     Walk begins at 10:00 am

        For more information visit www.walkforautism-charleston.com or call Erin at 971-1115.

NAME: __________________________________________________TEAM NAME/ IN HONOR OF: __________________________________________________

ADDRESS: ______________________________________________CITY: _______________________________STATE: ___________ ZIP CODE____________

PHONE NUMBER: _________________________________________ EMAIL: __________________________________________________________________________

NAME

ADDRESS / E-MAIL

PHONE NUMBER

DONATION AMOUNT

Total Amount Pledged   $ ______________Total Collected Today   $ ______________

All gifts are tax deductible; please make checks payable to walk for Autism– Charleston.

To avoid waiting in line on walk day, mail your form and donations to Walk for Autism– Charleston, P.O. BOX 60238, Charleston, SC  29419-0238. 

**All proceeds stay in the tri-county area and are awarded to families in the form of educational scholarships for in-home ABA / RDI and Alternative Therapies**

                                   

                                           


Copyright 2009
Walk for Autism Charleston