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Race for Education Sponsorship Form

Thank you for sponsoring a student in the Race for Education, 2012.   The class reps are pictured at the bottom of this page.  To make a flat donation, please fill out the amount below.  In the space next to "Race for Education", please type the runner's name that you are sponsoring.  Thank you.

Cause / Project Amount
Race for Education: $

To make a "per lap" donation, please fill out the form below.

Runner's Name

Runner's Grade

I will sponsor this student for:
$10 per lap   $5 per lap   $2.50 per lap   $1 per lap
Other (see below)

I would like to make a "per lap" pledge in the following amount
*

Name:
*

Address:
*

City:
*

State:
*

Zip Code:

* Enter Your Email Address:

  

4400 N. 6th Street, Philadelphia, PA 19140 // Main Phone #:  215-324-1050 // Fax #:  267-535-2777
Contact our Development Team // Phone #: 215-324-9180 // dod@hpcaphilly.org
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