A Benefit For:
The Dempsey Center
29 Lowell Street, 5th Floor Lewiston, ME 04240
Donations are tax deductible EIN #01-0211494
Donation Form Instructions
Pleaseencouragedonorstomaketheirdonationsonlineviayourpersonalwebpage–theywillreceiveimmediate acknowledgement,youwon’thavetofilloutthisformANDitwilllessenstafftimespentondataentry!
Thisformistobeusedfordonationsreceivedascashorcheckonly.Donotincludethosewho’vepledgedandnotyet paid or made donationsonline.
Complete the form (as legibly as possible!) including:
•Teamname,ifapplicable.
•First name, last name, phone and mailing address of the registered participant. Please complete for one participantperform.Ifyouwouldliketocreditmultipleparticipantsonateam,pleaseusetheTeamDonation formfoundonthewebsiteunderFundraising>Documents.
•Paymenttype:cashorcheck.Ifcheck,pleaseincludechecknumberforeachdonation.
•Completedonorinformationforeachdonationreceived.Ifwedonothavecompletedonorinformationwewill beunabletoissueadonorreceipt,whichisnecessaryifthedonorwishestoclaimtheirgiftasataxdeduction. Receiptswillbeissuedelectronicallyifanemailaddressisprovided.
Checks should be made payable to: The Dempsey Challenge. Please do not hold checks for longer than 2 weeks as a courtesy to donors.
Onceyouarereadytoturninyourdonations,calculatethetotaldollarsbeingpaidbycashandcheckandcomplete thetotalfieldsatthebottomrightoftheform.
Completedformsanddonationscanbemailedto:CMMCDevelopmentOffice,300MainSt.,Lewiston,ME04240or droppedoffattheDempseyCenter:29LowellSt,5thFloor,Lewiston,ME,M-F,8:00am-4:30pm.
You will receive an e-mail(s) when your donations are entered into our system if you have provided us with an emailaddress.Yourpersonalfundraisingpageshouldthenreflectthesedonationsandyournewfundraisingtotal! Hooray!
Questions?Please call the Development Office: (207) 795-2950 or e-mail mailto:.
Thank you for raising funds and awareness for those impacted by cancer!
Team name: Participant’s full name:
Phone:
Mailing Address:
A Benefit For:
The Dempsey Center
Donations are tax deductible
EIN #01-0211494