Save the Day
Commitment Form
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� LIFESAVER $10,000

Provides emergency relief for four days to victims of fires, floods and other disasters.
� SUPER HERO $7,500
Provides emergency relief for three days including training of Disaster Action Team volunteers.
� HERO $5,000
Provides emergency relief for two days including blankets, food and replacement medicines.
� CHAMPION $2,500
Provides emergency relief for one day including temporary housing and clothing.
� PATRON $1250
Provides emergency relief for half a day including maintenance service for emergency vehicles.
Provides emergency relief including comfort kits with soap, shampoo, toothpaste and other personal items.
� FRIEND $_____
donation will help the Red Cross provide emergency relief when help can't wait.

Please send check to:
American Red Cross
Save the Day
4800 Mt. Hope Drive
Baltimore MD 21215

Simply select your day and your pledge level (see side box) and then complete the following:
Choose Your Day(s): (mm/dd/yy)
Pledge Level (see box):
Company Address:  
State: Zip Code:
Contact Person:
Work Phone:
E-Mail Address:
Please charge my Day(s) to the following credit card account
(If you prefer to pay by check or be billed, please leave this section blank.)
MasterCard VISA
Credit Card Number

Exp. Date(mm/yy)

Cardholder's Name
Please bill me at the above address:

I would like to receive an email receipt:
I would like to receive a receipt by mail:
Do you need any additional information?  

How did you hear about this program? (optional)

How did you hear about our site? (optional)

  Our Chapter serves only the Central Maryland region. If your requests for information fall outside of our area, we may not be able to process them. Locate a Red Cross Chapter near you.

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