Mark Warble

Address: 4158 Utah St. #3, San Diego, CA 92104

Phone: 203.219.5535
Email: boyee98@aol.com
My Web site:
http://www.active.com/donate/tntsdh/WildflowerOrBust08
The Leukemia & Lymphoma Society: www.lls.org
Team In Training: www.teamintraining.org
The Triathlon at Pacific Grove:
http://www.tricalifornia.com/pgtri/2007/

SPONSORSHIP FORM
NOTE: If you make a donation online, you do not need to fill out this form.
Go to: www.active.com/donate/tntsdh/WildflowerOrBust08 (This site is safe and secure)

If you would like me to train and compete in honor of someone you care about, please list their
name(s) here. I will add their name(s) to my training and race shirts and to special honoree bracelets
worn throughout the event.

Honoree Name(s): _________________________________

_________________________________

CONTRIBUTION
_____ $25
_____ $50
_____ $75
_____ $100
_____ $ 250
_____ $ 500
_____ Other

THANK YOU FOR YOUR SUPPORT!

Name __________________________________ Phone ________________

Address _________________________________________________________
Email (optional) __________________________
Please make checks payable to The Leukemia & Lymphoma Society. To charge your
contribution to a credit card, please complete the following:
Visa __ Mastercard __ AMEX __
Card # __________________________ Exp. Date ________ Amount $ _____
Name on Card ____________________ Signature___________________________

-----------------------------------------------Detach Here----------------------------------------------

Please keep for your records. For your reference, LLS tax ID number is 13-5644916.

Donor’s Name ___________________________ Donation Date _________ Amount ______

Donor’s Address ______________________________________________________________________________
Street/PO Box City State Zip Code

In accordance with the Internal Revenue Code, the amount you donate is considered to be a charitable contribution to the
Society; your contribution is tax deductible as allowed by law. For questions regarding tax deductions, please contact your
accountant.