Pledge Form

We encourage any interested participants to collect pledges in an effort to further assist the funds raised by the VT 100 for Vermont Adaptive Ski and Sports! You can do this independently with this form or by starting a page through Active.com's program, Active Giving at  http://www.active.com/donate/vermont100.

Please make all checks out to: Vermont Adaptive Ski and Sports

 

DATE

NAME

ADDRESS

CITY-ST-ZIP

DONATION
AMOUNT

COMMENTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Amount Collected:                                     

 

Total Amount Collected by Registration Date - Friday, July 18th, 2014

 

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