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HOW TO PARTICIPATE ON
THE ALS MARCH OF FACES BANNER
Email or Send a photograph of the PALS, any size is
fine.* You are welcome to include family and/or caregivers in
the picture if you wish. Include the following information:
PALS'
Name:________________________________________
PALS' Date of Birth:___________________________________
PALS' Address:______________________________________
PALS' City, ST/Prov, Country, Zip:________________________
PALS' Email: ________________________________________
PALS' Phone (optional):____________________
PALS' Diagnosis Date: ____________________
(for memoriams) PALS' Date of Passing:_________________
(include contact's
information if applicable)
Contact
Name:________________________________________
Contact Address:______________________________________
Contact City, ST/Prov, Country, Zip___________________________
Contact Email: __________________________________________
Contact phone:___________________________________________
____ YES, I want this name listed on the Banner Website
(check
here)
Also include this permission notification:
By my own personal authority or power of attorney, I give
permission to use the photograph of _______________________
submitted to the ALS March of Faces to be printed on the ALS
March of Faces Banner© for purposes of Awareness, Advocacy and
Fundraising issues and events that concern or benefit People
with ALS (PALS).
__________________________________
Signature
______________
Date
Email your photo to: banner@march-of-faces.org
copy and paste the above form into the body of your email
OR
Mail to:
ALS March of Faces Banner
4016 Royal Wood Blvd.
Naples, FL 34112-8843
*photographs are enlarged to 5" x 7" portrait
orientation for banner imprint, landscape orientation photos
will incur cropping.
Your submission will automatically include you on the
e-mailing list for the ALS March of Faces OnLine Newsletter, a
monthly periodical that will keep you up to date with the goings
on of the Banner as well as breaking news on issues and events
that concern PALS, with articles written by and for PALS and
CALS.
If you wish to have your photo returned, please include a
self-addressed stamped envelope. |
