Sponsor Form
Yes, I would like to support Sandy in the New York Marathon to benefit Cystic Fibrosis.

___$1/mile   ___$2/mile   ___$3/mile   ___Other

Name:_________________________________________

Address:_________________________________________

City, State, Zip:_________________________________________

Phone:_________________________________________

Method of Payment:   Check______      Cash_____      Credit Card_____

Type of Card: VISA____      AmEx      M/C____   Discover____

Credit Card #:_____________________________Exp. Date:_______________

Signature:____________________________________

FAX: (716) 877-1090

Sandy Smith
148 Laurie Lane
Grand Island, NY 14072