Please X one of the following:

[  ]  Name of the person you are sponsoring

      ____________________________

[  ]  I wish all of the members of Team Sarcoma well and my donation covers all of them.

I want to aid sarcoma research and will make a donation to the Liddy Shriver Sarcoma Initiative.

Please X one of the following:

[  ]  $100

[  ]  $250

[  ]  $500

[  ]  $1000

[  ]  or, the amount of $___________

My Name:

Targeting Your Donations: You can specify that you would like your contribution applied towards a research study of a specific sarcoma. If you would like to do this, specify the sarcoma here:

________________________________________________

Donations: The Liddy Shriver Sarcoma Initiative is a Collective Giving Fund within FJC, a 501(c)(3) not-for-profit public charity and a Foundation of Philanthropic Funds. As such, all donations and gifts made to FJC that are designated for the Liddy Shriver Sarcoma Initiative are fully tax deductible to the extent allowed by law for US citizens.

My Address:

My Phone:

My E-Mail Address:

Check: Make your check out to "FJC/Liddy Shriver Sarcoma Initiative". If the donation is being made in honor or memory of someone, that person's name should appear on the memo line f the check. Send your check with this form to:

Liddy Shriver Sarcoma Initiative

17 Bethea Drive

Ossining, NY 10562-1620

Credit Card: To make a donation or sponsor someone on the 2008 Team Sarcoma Initiative by credit card: (1) Go to the “JustGive” website at http://tinyurl.com/2uw4y7; (2) In the “Designate My Donation” field enter, “Liddy Shriver Sarcoma Initiative”; (3) In the “As a gift in someone’s Name” field enter the name of the person you are sponsoring, else leave this field blank. You must enter the information in Steps 2 and 3 or the donation will not be properly credited to the Liddy Shriver Sarcoma Initiative or to the person you are sponsoring. JustGive charges a 3% fee for this service. For example, if someone donates $100, they will receive a $100 charitable tax deduction and the Liddy Shriver Sarcoma Initiative will receive $97. The email receipt you receive from JustGive meets the IRS requirements as a record of donation.

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