Registration - Dancing with the Stars - Benefiting Colon Cancer Research and Awareness

Sponsor(s) Name
Organization Name
Mailing Address

Contact Person	Phone
Email

Please indicate your level of sponsorship:

$10,000        Super Star Sponsor
$5,000          Shining Star Sponsor
$2,000          Shooting Star Sponsor
$1,000          Twinkling Star Sponsor
$500             Blue Star Projects Sponsor

Tickets for the masquerade ball are $100 per person and $150 per couple, which covers cocktails, dinner, and dancing.

	@ $100 per person $
	@ $150 per couple $
	Ticket Total $

Make a donation in memory of a loved or celebrate the survivorship of a friend or relative who continues the fight against colon cancer. The names of honorees will be highligted in the event program at gala.

Name

Please list names as you would like them to appear in the program.

In Memory of

In Honor of

Donation Amount $

Currently we are unable to process credit cards. The deadline for corporate sponsors is Feb 1st, 2008.
Please make checks payable to : USC Education Foundation - Colon Cancer Research

Mailing Address :
Center for Colon Cancer Research - University of South Carolina Attn: Anjee Davis
1212 Greene Street, Columbia, SC 29208

This form will be sent for our confirmation. We will contact you as soon as we process your registration.