Pledge to CareNet Dickson, TN

If you are signing up for the Sponsor A Day program please fill in the following information:

Yes, I would like to sponsor a day in honor of .

The special day is (ex. 01-25-2008)

Please select:

I would like to sponsor a whole day in the amount of $600.00

I would like to sponsor a half day in the amount of $300.00

I will send the whole amount.

If you'd like to send a monthly donation please check the following:

I would like to donate $50.00 per month to sponsor a whole day for a total of $600.00

I would like to donate $25.00 per month to sponsor a half day for a total of $300.00

You must fill in all information below this line for us to complete your pledge or sponsor information.
All information is kept confidential.

*Name:
*Address:
*City:
*State:
*Zip Code:
*Phone:
*e-mail:


	How can you be sure the information you send is secure? Look in the upper left corner of the URL address line, if you see 'https', the page is secure and you know whatever data you enter onto the page will be sent across the Internet securely. It is extremely unlikely the information can be intercepted and used by a third party for illegal reasons. If the characters you see however, are 'http', the web page you are viewing is not secure. At the bottom of this page you can click the Security Seal to check information about the CareNet Security Certificate. You can be assured that CareNet will not disclose any information provided and the information you send will be secure.