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Ride-A-Thon Donation Form
Ride-A-Thon 2009 is Saturday October 17th, 2009. Please mark your calendars.
Please fill out the form below (fields with an asterisk * are required). All information provided to us shall remain confidential.
*Submitter's Name:
Company:
Title or Position:
Address:
City:
State:
Zip Code:
*Submitter's Phone:
Fax:
*Submitter's Email:
*Donator's Name:
*Item Donated:
*Donator's Company:
*Donator's Phone:
*Donator's Email:
Businesses Approached for Ads:
Comments or questions:
CODE HINT: uppercase "W", lowercase "m", lowercase "q"
Please re-enter the security code shown above:
22532 Bowsher Road • Cridersville, OH 45806 PH: 419-657-2700 • Fax: 419-657-2887 •
