MDA Muscle Team® Boston Commitment Form

$20,000
$12,500
$6,500
$4,000
$800
$400 each

Program Ads

$5,000
$2,000
$1,300
$650
$325
$100
Camera-Ready black & white copy measuring 5" x 8"
MUST be received by Wednesday, December 19, 2007
     Unfortunately I cannot attend.
Company Name:
Contact Name:
Address:
City:
State:    Zip:
Phone:   Fax:
Email:
Enclosed is my check for $ payable to the Muscular Dystrophy Association (MDA)
Please bill my:                
Account Number:    Expiration Date:
Signature: ________________________________________________________
Please fill out this form, print it and sign it. Fax to: 617.368.9115 or mail to:

Muscle Team® Boston, c/o MDA
31 Milk Street, Suite 920
Boston, MA 02109
To become a sponsor by phone: 617-368-9155
To become a sponsor by email: