Date: SPONSOR INFORMATION Name of Business/Sponsor: Address: State: Zip Code: Phone: Donation Amt: HOPE for HARLEE SPONSORSHIP FORM Harlee's Story: After a routine eye exam, on September 29th 2017, the doctors discovered a tumor at the base of Harlee’s skull. She has been diagnosed with a very rare type of tumor called a Chordoma. About 1 in a million people get these skull based tumors and they are difficult to remove. On October 9th, 2017, Harlee had her first of two surgeries in an attempt to remove the tumor. She underwent a 5 hour surgery that left her with a very small section of tumor cells located near her carotid artery. Harlee was also left with some damage to the nerve that opens and closes her left eye lid. It remains shut now. On January 17, 2018, Harlee had her second surgery where more of the tumor was removed. Her surgeon felt it too risky during surgery to try and repair the damage to her nerve that opens and shuts her eye so that was left alone. Because the remaining tumor was not fully removed, Harlee will soon head off to go through weeks of proton beam radiation therapy that is not offered locally. I would like to make a one time donation. Small Other XXL XL Large Med I would like to purchase a t-shirt for $15.00. Please select size below. I have a logo I need a logo created I would like sponsor an ad on the t-shirt If you have a logo, please send to [email protected]. If you need a logo created please send your information and graphic you would like to use to [email protected]. The t-shirts will be designed several times for different events, but your logo will remain on the t-shirts. Follow Hopeforharlee on Facebook for upcoming events and updates on her recovery and process! Thank you for your support! Payment Check payable to Hope for Harlee Cash -Donations can be sent to PO Box 431 - Salem, VA 24153 -All cash donations will receive copy of the sponsorship form

SPONSOR INFORMATION SPONSORSHIP FORM€¦ · sponsor an ad on the t-shirt. If you have a logo, please send to [email protected]. If you need a logo created please send your information

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Date:

SPONSOR INFORMATIONName of Business/Sponsor:

Address:

State:

Zip Code:

Phone:

Donation Amt:

HOPE for HARLEE SPONSORSHIP

FORM

Harlee's Story: After a routine eye exam, on September 29th 2017, the doctors discovered a tumor at the base of Harlee’s skull. She has been diagnosed with a very rare type of tumor called a Chordoma. About 1 in a million people get these skull based tumors and they are difficult to remove. On October 9th, 2017, Harlee had her first of two surgeries in an attempt to remove the tumor. She underwent a 5 hour surgery that left her with a very small section of tumor cells located near her carotid artery. Harlee was also left with some damage to the nerve that opens and closes her left eye lid. It remains shut now. On January 17, 2018, Harlee had her second surgery where more of the tumor was removed. Her surgeon felt it too risky during surgery to try and repair the damage to her nerve that opens and shuts her eye so that was left alone. Because the remaining tumor was not fully removed, Harlee will soon head off to go through weeks of proton beam radiation therapy that is not offered locally.

I would like to make a one time donation.

Small OtherXXLXLLargeMedI would like to purchase a t-shirt for $15.00. Please select size below.

I have a logo I need a logo created

I would like sponsor an ad on the t-shirt

If you have a logo, please send to [email protected]. If you need a logo created please send your information and graphic you would like to use to [email protected]. The t-shirts will be designed several times for different events, but your logo will remain on the t-shirts.

Follow Hopeforharlee on Facebook for upcoming events and updates on her recovery and process! Thank you for your support!

Payment

Check payable to Hope for Harlee

Cash

-Donations can be sent to PO Box 431 - Salem, VA 24153 -All cash donations will receive copy of the sponsorship form