Young Survival Coalition (YSC) is the premier global organization dedicated to the critical issues unique to young women who are diagnosed with breast cancer. YSC offers resources, connections and outreach so women feel supported, empowered and hopeful. With an interactive website and 26 Affiliates across the United States, it is YSC's goal that no young woman is left to face breast cancer alone.

Panera Bread’s Swing For Life Golf Tournament - 10/08/2010 Prairie Highlands Golf Course Olathe, Kansas Print the official "Swing For Life Golf Tournament" Sponsorship Brochure for more information
Please enter a quantity for each box below:
	Platinum Level $4000.00
	Gold Level $2200.00
	Silver Level $1300.00
	Hole/Tee Sponsor $200.00
	Four Person Team $420.00
	Individual Player $110.00
	Total that will be charged to your credit card
Sponsor/Participant Information:
Name:
Email Address:
Company:
Address:
City:   State:   Zip:
Phone:

Credit Card Information
(We accept American Express, MasterCard, Visa, and Discover cards.)

* Card Type	American Express Discover Mastercard Visa
* Name on Credit Card
* Account Number
* Exp. Month	1 2 3 4 5 6 7 8 9 10 11 12	* Exp. Year	2010 2011 2012 2013 2014 2015