Home | Day's Events | Walker/Team Registration | Men of Leadership
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Please complete this SECURE online form to:

•Sponsor a Man of Leadership
•Donate Online
•be a Walker
•be a Team Captain
•be a Corporate Sponsor
•sponsor a Walker or Team
•make a Donation to the Silent Auction
•be a Volunteer

I'm interested in (check & fill in all that apply)

Sponsor a Man of Leadership
   Man of leadership name
                 Sponsor's name
                  Sponsor's eMail
                                Address
                           City/Town State Zip Code
                Sponsor's phone
                                                Amount of Donation $

     I am donating using my Visa    MasterCard  
        Name on Credit Card
          Credit Card Number Expiration Date CVV

Making a Donation to Taking Steps
                                    Name
                                     eMail
                                Address
                           City/Town State Zip Code
                                    Phone
                                                Amount of Donation $

     I am donating using my Visa    MasterCard  
        Name on Credit Card
          Credit Card Number Expiration Date CVV

Being a walker, please send me a free "Sponsor Me" pin
                           Name
                            eMail
                         Address
                      City/Town State Zip Code
                           Phone

Being a team captain, please send me a team captain packet
         Team Captain Name
          Team Captain eMail
                         Address
                      City/Town State Zip Code
                           Phone

                   Team Name
               Team Members

Being a corporate sponsor, please contact me
               Business Name
                Business eMail
               Business Phone Business Phone Ext.

Sponsor a Walker, contact me about my donation
               Walker's Name
              Sponsor's Name
               Sponsor's eMail
              Sponsor's Phone

                                    Amount of Donation $

     I am donating using my Visa    MasterCard    American Express    Discover
        Name on Credit Card
          Credit Card Number Expiration Date CVV

Sponsor a Team, contact me about my donation
                   Team Name
              Sponsor's Name
               Sponsor's eMail
              Sponsor's Phone

                                   Amount of Donation $

     I am donating using my Visa    MasterCard   
        Name on Credit Card
          Credit Card Number Expiration Date CVV

Donating an item for the silent auction, contact me about my item
          Silent Auction Item
                            Value
               Donator's Name
                Donator's eMail
               Donator's Phone

Being an event volunteer , contact me about volunteer opportunities with Taking Steps
              Volunteer Name
               Volunteer eMail
              Volunteer Phone

 

                         Write your message below   
                        

  

 

Home | Day's Events | Walker/Team Registration | Man of Leadership
Purpose | How you can help | Donate | Privacy

Questions?
Rape Crisis Center of Central Massachusetts
799 West Boylston Street, Worcester, MA 01606
508.852.7600  .  takingsteps@rapecrisiscenter.org