What is the YSC Summit?
The YSC Summit is a National Conference for young women affected by breast cancer and their co-survivors.
This national conference features the most up-to-date information about the unique needs of young women with
breast cancer. The conference will include inspiration speakers, empowering and fun events, educations
workshops, wellness activities and discussion groups to help survivors and co-survivors connect.
For more information on Summit Fundraisers please email [email protected]
If you would like to donate, please fill out this form and return it, along with the check, to YSC.
Summit Attendee’s Name____________________________________________________________
If donating to a Summit Fundraising team please indicate how you would like for your donation to be split:
Split my donation evenly among all team members
Split my donation evenly among these team members:_____________________________________________
Donor Name_____________________________________ Salutation (circle): Mr./Mrs./Ms./Miss/Dr.
Donor phone number: ________________________ Donor email: ______________________________
Donor Address__________________________________________________________________________
Are you a breast cancer survivor?
Yes
No
Please make checks payable to “Young Survival Coalition”.
Write the Summit Attendee’s FULL NAME along with “Summit Fundraising” in the memo field so that
he/she gets credited.
Donation amount $___________
If you would like to donate by credit card, check the appropriate box and fill in the information below:
AmEx
Discover
MasterCard
Visa
Credit Card Number:__________________________ Expiration Date:_____/______ Verification Code: ________
Don’t forget to ask your company about matching gifts!
Will this donation be matched by a company?
Yes
No
What is the company name that will match this gift? _____________________________
You can also donate online by going to http://summit.youngsurvival.org/fundraise
Please mail this form and your donations to the address below.
Young Survival Coalition, Attn: Summit Fundraising – 80 Broad Street, Suite 1700, New York, NY 10004