International Lap-a-Thon Pledge Forms

This form is a commitment in which a sponsor offers a pledge for the following DAIS student to run in the Lap-a-Thon on Saturday, February 11. We will only be accepting flat-rates.  All proceeds from this event will be used to support projects with the Atyrau Adaptation Center.

NAME of Student Participating in the Lap-a-Thon: ___________________________

Please return this form with the appropriate amount of money to the Student Council on Lap-a-Thon Day, February 11.

Name of Sponsor

Name of Runner

Amount of Money

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                                                 Total Amount :_______________________

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Total Amount :___________________