Fundraising Application A little about us: Our mission is to provide information and support services to families worldwide affected by Dyskeratosis Congenita and Telomere Biology Disorders, to encourage the medical community’s research in finding causes and effective treatments, and to facilitate improved diagnosis by educating medical providers. We are a 501(c)(3) organizations, so any contributions you make to Team Telomere are tax deductible. A little about you: You’re ready to hit the ground running (or biking or swimming) to help raise funds for Team Telomere by joining #teamtelomere! Your participation in any race while wearing our logo helps let people know who we are and the money raised helps keep us going. How this works: You join #teamtelomere and pledge to raise a minimum of $200 for Team Telomere and we’ll hook you up with a great race shirt and reimburse your race fee up to $75. If you raise $1,000 or more, we will cover the entire race fee! Just hang on to your race entryconfirmation, raise some money, and we’ll virtual high five you at the finish line. Finally: We are so grateful for your support and efforts to help us continue to fulfill our mission! The nitty gritty: Complete this form and send it to Katie Stevens at email@example.com. Name* First Middle Last Date* Date Format: MM slash DD slash YYYY Address* Street Address Apartment/Unit # City State ZIP / Postal Code Phone*Email* Date of Race*Location*Type (5k, Marathon, etc)*Race Entry Fee*T-shirt Size*Are you willing and able to commit to raising a minimum of $200 for #teamtelomere?* Yes No Do you agree to raise all funds solely for Team Telomere for this race?* Yes No Signature*Date* Date Format: MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged.