Onward Upward Online Pledge Form

Instructions:

1. Enter & Submit Information and Donation Amount (No money due at this time)

2. A bill will be sent to your Mailing Address in April or May. The bill will come from Penn State, and will include all appropriate tax information for the appropriate tax deduction. No credit card information is needed and no payment will be due until time of billing.

All proceeds go to the Penn State Dance Marathon, which benefits children with cancer and research at the Hershey Medical Center. Additional information can be found at http://www.thon.org

First Name:
Last Name:
Email Address:
Mailing Address Street:
Mailing Address Street 2
City
State:
Zip Code
Please select the team that you are pledging on behalf of:
Pledge Amount:	$5 $10 $25 $50 $100 $125 $150 $200 $250 $500 $750 $1000
Company Match	Yes, my company will match my pledge & I will ensure this process is completed. (Many companies are set up & approved to match for Penn St Dance Marathon as they likely have contributed as a firm in the past. Please contact Onward Upward w/ questions)
Confirmation (Required)	Upon successful submission of this form, I understand that I will receive a bill from Penn State University in the April/May Timeframe.