American Cancer Society



American Cancer Society

Relay For Life

of University of Northern Iowa

Light the way to a cure . . .

On Friday, April 17, 2009 a special luminaria ceremony will take place at the Relay For Life of UNI to remember and honor family and friends who have battled cancer.

With your suggested $10 donation per bag, a luminaria will be placed along the Relay For Life of UNI pathway to memorialize or honor someone you love. A personal message can be added to the luminaria along with the individual’s name.

|In |In |Name to be put on each luminaria bag |

|memory|honor|Message |

|of |of | |

( ( Bag 1: ______________________________________

____________________________________

( ( Bag 2: ______________________________________

____________________________________

( ( Bag 3: ______________________________________

____________________________________

Your Name: ___________________________________________

Address: ______________________________________________

City: _________________________________________________

State: ______________________Zip: _______________________

Phone: (_____)_________________________________________

Make your check payable to: American Cancer Society and return to your Relay Team Captain or mail with this form to:

Relay For Life/Colleges Against Cancer

Student Organizations Center

Maucker Union 0166

Cedar Falls, IA 50614-0166

American Cancer Society

Relay For Life

of University of Northern Iowa

Light the way to a cure . . .

On Friday, April 17, 2009 a special luminaria ceremony will take place at the Relay For Life of UNI to remember and honor family and friends who have battled cancer.

With your suggested $10 donation per bag, a luminaria will be placed along the Relay For Life of UNI pathway to memorialize or honor someone you love. A personal message can be added to the luminaria along with the individual’s name.

|In |In |Name to be put on each luminaria bag |

|memory|honor|Message |

|of |of | |

( ( Bag 1: ______________________________________

____________________________________

( ( Bag 2: ______________________________________

____________________________________

( ( Bag 3: ______________________________________

____________________________________

Your Name: ___________________________________________

Address: ______________________________________________

City: _________________________________________________

State: ______________________Zip: _______________________

Phone: (_____)_________________________________________

Make your check payable to: American Cancer Society and return to your Relay Team Captain or mail with this form to:

Relay For Life/Colleges Against Cancer

Student Organizations Center

Maucker Union 0166

Cedar Falls, IA 50614-0166

American Cancer Society

Relay For Life

of University of Northern Iowa

Light the way to a cure . . .

On Friday, April 17, 2009 a special luminaria ceremony will take place at the Relay For Life of UNI to remember and honor family and friends who have battled cancer.

With your suggested $10 donation per bag, a luminaria will be placed along the Relay For Life of UNI pathway to memorialize or honor someone you love. A personal message can be added to the luminaria along with the individual’s name.

|In |In |Name to be put on each luminaria bag |

|memory|honor|Message |

|of |of | |

( ( Bag 1: ______________________________________

____________________________________

( ( Bag 2: ______________________________________

____________________________________

( ( Bag 3: ______________________________________

____________________________________

Your Name: ___________________________________________

Address: ______________________________________________

City: _________________________________________________

State: ______________________Zip: _______________________

Phone: (_____)_________________________________________

Make your check payable to: American Cancer Society and return to your Relay Team Captain or mail with this form to:

Relay For Life/Colleges Against Cancer

Student Organizations Center

Maucker Union 0166

Cedar Falls, IA 50614-0166

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