You can use your donation to purchase Climb Against the Odds commemorative items. A part of your purchase is a tax deductible contribution to The Breast Cancer Fund (see note below). For a donation of $100 and over, you may dedicate a Prayer Flag (see item below). Your name or that of a loved one will be inscribed on a Prayer Flag to symbolize the hope of those living with breast cancer and to honor the memories of those who have passed on. These flags will later be made part of a permanent exhibit. A certificate and pin will be sent acknowledging your prayer flag dedication. To order please print this order form and mail or fax it to The Breast Cancer Fund or call 415-543-2979.
| Qty. | Item | Cost | Total | |
| _____ | Climb Against the Odds T-shirt (white) | ___M ___L ___XL | @ $20 each | $__________ |
| _____ | Climb Against the Odds Adjustable Cap | @ $20 each | $__________ | |
| _____ | Prayer Flag Pin (no dedication) | @ $5 each | $__________ | |
| _____ | Prayer Flag Dedication | @ $100 each | $__________ |
Name to be honored _____ or memorialized _____ (check one) on Prayer Flag ____________________________
Name and Address of person(s) to revive Prayer Flag Acknowledgement certificate and pin:
Name ________________________________________________
Address ______________________________________________
City_____________________________ State __________ Zip _________
Name of person's giving the Prayer Flag. _________________________________________
___$20 ___$50 ___$100 ____$250 ___other $________
| 8 1/2 % Sales Tax (in California and no applicable to Prayer Flags) | $__________ |
| Shipping ($3.00 each item except Prayer Flags and Pins) | $__________ |
| Non-merchandise donation enclosed | $__________ |
| Total | $__________ |
Name ________________________________________________
Address ______________________________________________
City_____________________________ State __________ Zip _________
Phone _____________________ (daytime) ____________________ (evening)
_____ Please send information about how I can participate in A STEP AHEAD program.
Please make check payable to The Breast Cancer Fund and send to:
282 Second Street, Second Floor, San Francisco, CA 94105-3130
or fax credit card number and order form to 415-543-2975
VISA/MC/AMEX # ________________________________________ EXP. Date __________
Signature ________________________________________________
Note: The estimated value of each T-shirt is $5, each hat $10 and each Prayer Flag Pin is $2. Your donation in excess of these values is tax deductible as a charitable contribution. Donations for Prayer Flags are entirely tax deductible. Shipping applies only to T-shirts and hats.