Mozcation Movember Fundraiser Pledge Form

Please let us know your name and contact information so we can confirm the pledge and the amount per check in you will be donating. We will count the number of people (up to 50) who have checked in starting at 5:00pm until close of business at The Music Hall venue on foursquare during the event on 11/7. Please note that we will be counting a maximum of 50 check ins for this event (so if you pledge $1 per check in the maximum donation you would then need to make would be $50 if we got 50 check ins). No pledge per donation amount is too small. We will follow up with you after the event to let you know the final number of total checkins and how to make your donation. THANK YOU! For more information about the event: http://mozcation-portsmouth.eventbrite.com/ and http://portsmouthfoursquare.com For questions please contact walterelly@gmail.com THANKS!
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