WBW 2011 - Talk To Me About Breastfeeding

WBW 2011 - Talk To Me About Breastfeeding Event Pledge Form
By submitting a pledge, WABA will showcase your picture and event by creating a Speech bubble on our World Wall Mosaic on the WBW website www.worldbreastfeedingweek.org
1) Personal Details:
Full Name*

First NameLast Name
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
2) Event Details:
Name of Organisation / Group
Website
Name of Event*
Description of Event*
Time & Date*
Place*
Country*
Language(s) Used*
Expected # of Participants*
I / We plan to translate the WBW materials*

YesNo
Languages Translated
3) Submit a photo (at least 640 x 480 jpg format):
UPLOAD PHOTO*

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4) OPTIONAL DONATION - Celebrate for a Cause!

Since the inaugural year of WBW celebrations in 1991, WABA has paved the way for hundreds of countries to join together and protect, promote, and support breastfeeding in their communities. Our work would not be possible without generous messages and actions of support from people like you. YOU are the reason why WBW exists, and YOU and YOUR COMMUNITY are the reason we continue to celebrate each year. We invite you to give back and show your gratitude for the folks who started it all during our commemorative 20th anniversary year. Those who give $1000 USD or more will receive a complimentary full-sized 7'x3' WBW banner! But, every bit counts! Don't hesitate to contribute whatever you can. This will ensure that WBW remains an ongoing and dynamic campaign for years to come!
Please enter amount (ex: 50.00)

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5) Questions or Comments?
Let us know!
Electronic Signature:
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WBW 2011 - Talk To Me About Breastfeeding Event Pledge Form

By submitting a pledge, WABA will showcase your picture and event by creating a Speech bubble on our World Wall Mosaic on the WBW website www.worldbreastfeedingweek.org

1) Personal Details:

2) Event Details:

3) Submit a photo (at least 640 x 480 jpg format):

4) OPTIONAL DONATION - Celebrate for a Cause!

5) Questions or Comments?

Electronic Signature: