Thank you for your pledge to our Star Fest Telethon VIP. Please enclose this pledge form with your contribution and mail to:





United Cerebral Palsy
206 Water Street
Eau Claire, WI 54703

 
 
VIP: Duane Hookom        Date Called: Internet Pledge
 
Pledge: $_______________ Amount Paid: $_______________ Date Paid: ________________
 
I understand that UCP is a recipient of area United Ways and that this donation will not affect my support to these funds.
 
Donor Signature: _____________________________________
 
Phone #: __________________________
 
Donor Name: _____________________________________
 
EMail: _____________________________________
 
Address: _____________________________________
 
_____________________________________

Would you like your pledge to be read on the air? YES_____ NO_____