DONATION FORM You may donate to the CT Challenge online at CTChallenge.org. This is a quick and secure transaction using your credit card or debit card. You may also donate by check. Please fully complete this form and enclose it with your gift.
If this donation is from a company or foundation, please complete the following:
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Company / Foundation Name
I am making a general donation to the CT Challenge I am donating in honor of:
Company Name & Phone
DONOR INFORMATION DOUBLE YOUR DONATION WITH A MATCHING GIFT
Name
To increase the impact of your donation, please check with your HR Department or online at bike.ctchallenge.org/matchinggifts-search to see if your employer will match your gift. Matching gift forms can be submitted to:
Address
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CT Challenge 250 Pequot Avenue Southport, CT 06890
Zip
Email (Provide email to receive an automatic receipt for your taxes. Your email will be used for no other purpose.)
Amount of Donation $ Check # (IMPORTANT)
I would like to receive future communications from the CT Challenge:
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If “Yes,” I prefer
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No
Either is fine
If you would like to make your donation in honor or memory of another person, please list that information below.
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In honor of
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In memory of
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In support
Please make your check payable to “CT Challenge” and mail with this fully completed form to: CT Challenge P.O. Box 566 Southport, CT 06890
ABOUT THE CT CHALLENGE CT Challenge programs are dedicated to changing the status quo for the 14.5 million cancer survivors in CT and throughout the U.S. Through exercise, nutrition, mind-body health and community-building support programs, we’re helping survivors reclaim, improve and prolong their lives after treatment is done. CT Challenge, Inc. is a 501(c)(3) charitable organization. All contributions are tax deductible to the extent of the law. Tax ID#: 20-2777748. Thank you for your support for the CT Challenge. All who battle cancer will benefit from your donation.