The Pumpkin Run Pledge Form amazonaws com

The Pumpkin Run Pledge Form Student Name: ___________________________ Sponsor Name and Address

Grade: ____________

How would like to sponsor your runner? Flat Amount: __________ or Pledge Per Lap: ________

Flat Amount: __________ or Pledge Per Lap: ________

Flat Amount: __________ or Pledge Per Lap: ________

Flat Amount: __________ or Pledge Per Lap: ________

Flat Amount: __________ or Pledge Per Lap: ________

Payment? Visa MasterCard Discover Amex Check Cash Visa MasterCard Discover Amex Check Cash Visa MasterCard Discover Amex Check Cash Visa MasterCard Discover Amex Check Cash

Card Info: Number: _____________________________________________

Visa MasterCard Discover Amex Check

Number: _____________________________________________

Exp Date: ___________________ CVV: _______________ Number: _____________________________________________ Exp Date: ___________________ CVV: _______________ Number: _____________________________________________ Exp Date: ___________________ CVV: _______________ Number: _____________________________________________ Exp Date: ___________________ CVV: _______________

Exp Date: ___________________ CVV: _______________

Cash

Flat Amount: __________ or Pledge Per Lap: ________

Flat Amount: __________ or Pledge Per Lap: ________

Flat Amount: __________ Or Pledge Per Lap: ________

Flat Amount: __________ Or Pledge Per Lap: ________

Visa MasterCard Discover Amex Check Cash Visa MasterCard Discover Amex Check Cash Visa MasterCard Discover Amex Check Cash Visa MasterCard Discover Amex Check Cash

Number: _____________________________________________ Exp Date: ___________________ CVV: _______________ Number: _____________________________________________ Exp Date: ___________________ CVV: _______________ Number: _____________________________________________ Exp Date: ___________________ CVV: _______________ Number: _____________________________________________ Exp Date: ___________________ CVV: _______________

Steps for Donating Online: 1. Go to http://stambroseschool.org/support-us/on-line-giving/ 2. In one of the blank fields, enter "PUMPKIN RUN-Student's Name" under description and the $ amount under Price. If you are sponsoring more than one student, use additional blank fields. 3. Click "continue" and follow the instructions. 4. We will be notified of your pledge and will credit the student(s)!