The document is a donation form for The Leukemia & Lymphoma Society. It lists several donation amounts that correspond to aspects of the donor's upcoming training for a race to benefit the organization. It requests the donor's contact information and payment details. It notes that employer matching funds could increase a donation and that contributions are tax-deductible. Space is provided to honor someone affected by blood cancer with the donor's run.

1. DONATION FORM
Yes, you want to help raise money for The Leukemia & Lymphoma Society!
$160 That’s $10 for each week I will be training
$105 That’s $8 for each mile I will be running in the race
$80 That’s $5 for each weekend morning I will wake up at 7 a.m. to train
$52 That’s $15 for each month of the training
$ The amount you are happy to donate instead of having to train 
* If your employer matches funds, you can increase your contribution! Ask your Human
Resources/Benefits department for the appropriate forms.*
Your name
Street address
City, state, zip
Please make checks payable to LLS and send to me by September 22, 2010.
If you prefer to make a contribution by credit card, please complete the following:
Visa / Mastercard / American Express (circle one)
Card number Exp. date
Name on Card Signature
All contributions are 100% tax-deductible. Approximately 75% of the Society’s total expenses
support research and patient services. For more information about The Leukemia &
Lymphoma Society, visit www.lls.org.
If you would like me to run in honor of someone you care about who has been affected by a
blood cancer, please list the name(s) here.
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