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Get Relay For Life Luminaria Form 2020

Luminaria Order Form Would You Like to Honor a Loved One Who Has Survived Cancer or Remember Someone Lost to Cancer Luminaria will be displayed at the Relay For Life of Voorhees High School on June 1 2012 during the candle-lighting Remembrance Ceremony. Luminaria is a 10. 00 donation per bag. Please complete the form below and return with payment to American Cancer Society Attn RFL of Voorhees H. S* 7 Ridgedale Ave Suite 103 Cedar Knolls New Jersey 07927 Please make checks payable to American Cancer Society. Team Name Participant Name This Luminaria is please check one In Honor Memory Name on Luminaria please write clearly Price Per. Total Qty X price Qty TOTAL QTY and ADDITIONAL DONATION TOTAL ENCLOSED Purchased By Phone Address City/State Zip Email For payment by Credit Card please complete the following Credit Card Holder s Name Card Number Expiration Date Card Holder s Phone Number Total Amount Signature VISA MasterCard AmEx Discover. Luminaria is a 10. 00 donation per bag. Please complete the form below and return with payment to American Cancer Society Attn RFL of Voorhees H. S* 7 Ridgedale Ave Suite 103 Cedar Knolls New Jersey 07927 Please make checks payable to American Cancer Society. S* 7 Ridgedale Ave Suite 103 Cedar Knolls New Jersey 07927 Please make checks payable to American Cancer Society. Team Name Participant Name This Luminaria is please check one In Honor Memory Name on Luminaria please write clearly Price Per. Team Name Participant Name This Luminaria is please check one In Honor Memory Name on Luminaria please write clearly Price Per. Total Qty X price Qty TOTAL QTY and ADDITIONAL DONATION TOTAL ENCLOSED Purchased By Phone Address City/State Zip Email For payment by Credit Card please complete the following Credit Card Holder s Name Card Number Expiration Date Card Holder s Phone Number Total Amount Signature VISA MasterCard AmEx Discover. Luminaria is a 10. 00 donation per bag. Please complete the form below and return with payment to American Cancer Society Attn RFL of Voorhees H. S* 7 Ridgedale Ave Suite 103 Cedar Knolls New Jersey 07927 Please make checks payable to American Cancer Society. Team Name Participant Name This Luminaria is please check one In Honor Memory Name on Luminaria please write clearly Price Per. S* 7 Ridgedale Ave Suite 103 Cedar Knolls New Jersey 07927 Please make checks payable to American Cancer Society. Team Name Participant Name This Luminaria is please check one In Honor Memory Name on Luminaria please write clearly Price Per. Total Qty X price Qty TOTAL QTY and ADDITIONAL DONATION TOTAL ENCLOSED Purchased By Phone Address City/State Zip Email For payment by Credit Card please complete the following Credit Card Holder s Name Card Number Expiration Date Card Holder s Phone Number Total Amount Signature VISA MasterCard AmEx Discover.

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