Hunter Donor Form
1
* * C h a r c o t - M a r i e - T o o t h A s s o c i a t i o n * * C i r c l e o f F r i e n d s The CMTA Circle of Friends... Working Together for a Cure! Charcot-Marie-Tooth Association 2700 Chestnut St Chester, PA 19013 Tel: 1-800-606-2682 Fax: 610-499-9267 www.charcot-marie-tooth.org [email protected] Hunter’s Quest for the Cure — Raising Funds for CMT Research Hunter, and thousands of other children with CMT, share a dream. They want to run, jump, and dance like the other kids do, but for many of them even the simplest activities of daily life can be challenging. We admire Hunter’s courage and determination in meeting the challenges he faces because of his CMT, and we are glad that he and his family are doing everything they can to help us find a cure. Through our Strategy to Accelerate Research (STAR), an initiative that has the goal of finding effective treatments within three to five years, we are also doing everything we can at the CMTA to ensure a brighter future for everyone who is affected by CMT. That includes making sure that every penny of every dollar you donate in support of Hunter is actually used to fund research by the best scientists in the world. With your generous support of Hunter’s Quest, you will bring us that much closer to our goal of a world without CMT. Thank you. Donor Information (Items marked with an asterisk “*” are required): *Name: ______________________/_______/__________________________________ First MI Last *Address: _______________________________________________________________ *City: ________________________ *State: _____ *ZIP: ________________ *Country/Postal Code (If not US): _________________ *Daytime Phone: _____________________ Evening Phone: _____________________ Email: _____________________________ In support of Hunter’s Quest for the Cure, I would like to make a tax- deductible donation to the CMTA in the amount of: $25 $50 $100 $250 $500 Other: $___________ If you are making your donation in honor or in memory of someone, please complete this section: In honor In memory of: Name: __________________/_______/_____________________________ First MI Last Please send an acknowledgement to: Name: __________________/_______/_____________________________ First MI Last Address: ______________________________________________________ City: _______________ State: ____ ZIP: _________ Payment Method: Check payable to the CMTA Money Order Credit Card American Express MasterCard VISA Card Number: ______________________________________ Expiration Date: ________________
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Transcript of Hunter Donor Form
** Char
cot-
Marie-Tooth Association
**
Circle of Friends
The CMTA Circle of Friends...Working Together for a Cure!
Charcot-Marie-ToothAssociation
2700 Chestnut StChester, PA 19013
Tel: 1-800-606-2682Fax: 610-499-9267
Hunter’s Quest for the Cure — Raising Funds for CMT Research Hunter, and thousands of other children with CMT, share a dream. They want to run, jump, and dance like the other kids do, but for many of them even the simplest activities of daily life can be challenging.
We admire Hunter’s courage and determination in meeting the challenges he faces because of his CMT, and we are glad that he and his family are doing everything they can to help us find a cure.
Through our Strategy to Accelerate Research (STAR), an initiative that has the goal of finding effective treatments within three to five years, we are also doing everything we can at the CMTA to ensure a brighter future for everyone who is affected by CMT.
That includes making sure that every penny of every dollar you donate in support of Hunter is actually used to fund research by the best scientists in the world.
With your generous support of Hunter’s Quest, you will bring us that much closer to our goal of a world without CMT. Thank you.
Donor Information (Items marked with an asterisk “*” are required):
*Name: ______________________/_______/__________________________________ First MI Last *Address: _______________________________________________________________ *City: ________________________ *State: _____ *ZIP: ________________ *Country/Postal Code (If not US): _________________ *Daytime Phone: _____________________ Evening Phone: _____________________ Email: _____________________________ In support of Hunter’s Quest for the Cure, I would like to make a tax-deductible donation to the CMTA in the amount of:
$25 $50 $100 $250 $500 Other: $___________ If you are making your donation in honor or in memory of someone, please complete this section:
In honor In memory of:
Name: __________________/_______/_____________________________ First MI Last
Please send an acknowledgement to:
Name: __________________/_______/_____________________________ First MI Last
Address: ______________________________________________________ City: _______________ State: ____ ZIP: _________ Payment Method:
Check payable to the CMTA Money Order Credit Card American Express MasterCard VISA Card Number: ______________________________________ Expiration Date: ________________
