Cheerleaders for Charity



To pay by check, Fill out and print this form before you click Submit

Enclose a $10 check & mail to:
Cheerleaders for Charity, Inc.
620 Hill Top Road
Hummelstown,  PA  17036
Your Username and Password will be e-mailed

Today's Date  Example:  09-27-2007
Full NameFirst     Last   
E-Mail Address
Mailing AddressStreet   City

State   Zip
Date of Birth   Example:  09-29-2007

Phone Number
Enter number with NO spaces


Ex:  5554449999
Home   School       Cell   Work   
Chapter Number Requested
I agree with the Code of Conduct

To pay by check, Fill out and print this form before you click Submit

Enclose a $10 check & mail to:
Cheerleaders for Charity, Inc.
620 Hill Top Road
Hummelstown,  PA  17036
Your Username and Password will be e-mailed

All Rights Reserved Cheerleaders for Charity, Inc. 2007