sponsor form first attempt
Transcription
sponsor form first attempt
PINKATHLON Maureen GRALL, Mairie D’Amou, D’Amou, 40330 AMOU ETel: 06 24 90 06 71 E-mail: [email protected] SPONSOR FORM FORMULAIRE DE PARRAINAGE WALKING TOGETHER AGAINST BREAST & PROSTATE CANCER MARCHONS ENSEMBLE CONTRE LE CANCER DU SEIN ET LA PROSTATE Please sponsor me as I am taking part in a 7 kms Walk against Breast and Prostate Cancer in Amou on September 23rd 2007. All funds are for “Cancer du Sein – Parlons en”registered charity number 0952008782 and “Breakthrough breast Cancer”, registered charity number 1062636 both committed to Breast Cancer Research and the Beatson Oncology Prostate Centre in Glasgow. **************************************** Merci pour votre parrainage a l’occasion de la Marche Contre le Cancer du Sein, marche de 7kms, a laquelle je participerai le 23 Septembre 2007 a AMOU. L’ensemble des fonds récoltes sera remis aux associations “Cancer du Sein—Parlons en” numero declaree a la sous prefecture 0952008782 et “Breakthrough Breast Cancer” numero 1062636 toutes deux particulièrement impliquées dans la recherche d’un traitement contre le cancer du sein et Beatson Oncology centre a Glasgow Participant’s name/ Nom: ____________________ Signature:_________________________ Address: ______________________________________________________________________ Sponsor Name Nom de Sponsor Sponsor Address (or / ou E-Mail) Amount Sponsored Montant du Don (£/€) Date Received Date recu