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Last modified: December 1, 2009
 
    Contribution Sheet:

LONG ISLAND RIDING FOR THE HANDICAPPED, ASSOCIATION

MAJOR EVENT - ANNUAL WALK-A-THON TO BENEFIT THE LIRHA STUDENT                  

  We thank you for all your support!

Minimum Pledge of $25.per person- is greatly appreciated to help offset expenses.

                        Mail donations to: L.I.R.H.A. P.O. Box 352 Glen Head, NY  11545

                                        Make checks payable to L.I.R.H.A

Name:
Address:
City:
Zip:
e-mail address:
Telephone:
My Goal  Amount $                                                                                                                                    

Please Print Legibly - So We Can Get Your Donation "Thank You" Card To You.

Signature: Date:

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