Bike MS

National MS Society, Greater Delaware Valley Chapter

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2014 Bike MS: City to Shore Prize & Plaque Request Form

 

DEADLINE: OCTOBER 31, 2014

RAISE AN ADDITIONAL $500 BY OCTOBER 31 AND BE ENTERED TO WIN 2 FREE AIRLINE TICKETS TO ANYWHERE IN THE WORLD QATAR FLIES.

                                                        -Courtesy of Qatar Airways

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Date of Birth:

 

 

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Anniversary Year Plaque Request

Note: If you do not request a plaque, one will not be ordered for you.

 

 


 


 

VIP Plaque & Jersey Request

Note: If you do not request a plaque, one will not be ordered for you. If you raised $1,000-$2,499, you should have received your plaque in Ocean City.

 

 


 


 
Question - Not Required - If you would like us to mail you a VIP Jersey, what size would you like?






 

Fundraising Levels

$650-$999: Sweatshirt*
$1,000-$2,499: Gold Level
$2,500-$4,999: Platinum Level
$5,000-$13,999: Diamond Level
$14,000-$19,999 Mission Possible Level
$20,000-$24,999: Tour of Champions
$25,000+**: Millennium Circle

 

 

Prize Request

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Question - Required - Would you like a prize?


 

FIND OUT WHAT NEW PRIZES ARE BEING OFFERED IN 2014!

How it works

> You will receive your prize code and the redemption website in the mail, and by email soon after we receive your Prize Request Form

> You will have 90 days to visit the website provided and select the prize of your choice

>> You may pick from a lower prize level

>> Only one prize per person

>> No exchanges

> You will receive a notification from the prize company Summit Group

*Prize redemption only, no plaque

**Prize(s) valued at $600 or more are considered income by the IRS and, as such, you are required to pay tax on that income. The Chapter must, by law, obtain your social security number and report such income to the IRS if you choose a prize(s) valued at this amount.

 

Comments:

Questions? Contact Lauren Trager at 1-800-445-BIKE or by email.

 

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