UCP Short Walk 2010 form and John Hoffland Celebration

Please call UCP at 715-832-1782 for a Short Walk Pledge form and more information. Thank you!

Pictured below is our lovely three-year-old 2010 UCP Feature Child, Christina Kademan, of Eau Claire.

For information on how you can volunteer your talents or to make a donation to UCP's 2010 Telethon, please call
Warren Petryk, UCP Telethon Coordinator, at
715-832-1782 or call 832-4UCP (-4827) on Telethon Saturday, January 30th.

Or feel free to fill out the form below

1.Information

First Name*

Last Name*

Address*

State*

Zip*

Phone Number*

2.E-mail address.

Email Address*

3.I am interested in helping UCP by:*

	1) Volunteering for the UCP Star Fest Telethon

	2) Volunteering for a UCP consumer program activity

	3) Making a monetary or in-kind services donation to help UCP continue serving people with disabilities who live in Western Wisconsin

	4) Becoming a Business/Corporate Partner Sponsor for a UCP Special Event Fundraiser

	5) Becoming a Respite Caregiver for people with disabilities

4.Please enter your date of birth.

Month*		Day*		Year*


	5.Terms and Conditions

	YES, I have read, understand, and agree to the Web site usage agreement and privacy policy.


	* represents required fields Children under the age of 13 may not submit this form.