DONATIONS

We run/walk on behalf of two patients, Alexandra Poudrier and Debi Moretta.  Alex was diagnosed with Acute Lymphocytic Leukemia in 1995.  She is a cancer survivor.  Debi was diagnosed with Acute Myeloid Leukemia in 2002 and is now fighting the disease.  Your contributions help people like Alex and Debi and fund the research to find a cure.  Please join our team by filling out the donor form and making your tax-deductible contribution. Donating is easy!  First, print this web page on your printer.  Second, fill-out the form.  Third, mail the form by November 16, 2002 to:

Janine & Jim Stolze
11760 Wickford Place
Yucaipa, CA  92399

Yes, I would like to contribute to Janine and Jim’s "Insane Campaign" in support of Alexandra Poudrier, Debi Moretta, and The Leukemia & Lymphoma Society.

Please circle the appropriate contribution below.

  $20.00 "Let’s See If They Can Finish" Division
  $52.40 "A Buck a Mile; That’s Not Too Bad!" Division
  $75.00 "They’re Kind of Cute When They Sweat" Division
$100.00 "Thank Goodness I’m Healthy!" Division
$200.00 "There’s No Way I Could Do It!"  Division
$500.00 "I Need a Big Tax-Deduction This Year" Division
$_____ "Be Creative; Make Up Your Own" Division

Please make your check payable to The Leukemia & Lymphoma Society and mail it back to us by November 16, 2002.

Name: ___________________________________________

Address: _________________________________________

City, State, Zip: ____________________________________

Phone:  __________________________________________ so we can call and thank you

E-mail Address: ___________________________________  so we can keep you posted on our progress

To charge your contribution to a credit card, complete below:

MC/Visa/Amex circle one  #____________________________

Expiration Date:  ___________________________________

Name on Card:  ____________________________________

Signature: _________________________________________