Be an Achieve  Sponsor

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Payment options and team registration appear after this form.

Please press the "Submit" button on the form above before making payment.  

Charitable Selection:

___ The LYN Fund:  Make check to "The LYN Fund"

___ Mammography Voucher Program:  Make check to "Morton Plant Mease Foundation"

Mail check and copy of this form to:

Charlene Mixa

5048 Pinnacle Drive

Oldsmar, FL  34677

For additional information, call:

727.753.3111

Submit the form above and make a Charitable Selection below:

Select The LYN Fund:

Select Mammography Voucher Program:

OR

An Achieve Sponsorship includes two foursomes on the day of the event.  Please provide that information below or call 727.215.9862 to provide it as soon as possible so that we can properly plan the event.

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 by the ELW Drive for a Cure.  All rights reserved.  2019

FLORIDA REGISTRATION NUMBER CH60670:  ACOPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE (800-435-7352) WITHIN THE STATE.  REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE