The Leukemia & Lymphoma Society
5845 Richmond Highway, Suite 800
Alexandria, VA 22303
Phone 703.399.2900
Fax: 703.399.2901
Email: kelly.kent@lls.org

For more information regarding the Leukemia Ball, please fill out the
form below, click submit and someone from LLS will be in touch
with you shortly. Thank you for your interest in supporting The Leukemia
& Lymphoma Society.

Name:
Date: 7/30/2010
Company:
Phone:
Fax:
Email:
I am interested in:
If you are purchasing a raffle ticket, how did you hear of the raffle?
 
Comments:
 

Due to DC Charitable Games Control Board regulations, we are not able to
take your credit card information via the internet. However, if you call
the Society directly, someone can assist you.