2014 - zeta phi beta sorority, · pdf filesample press release ... 2013 march of dimes...

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Zeta Phi Beta Sorority, Inc. Mary Breaux Wright 24 th International Grand Basileus Rauchelle Jones National Director of Programs & Initiatives Latasha Wilson Lane & Maryam J. Lynch-Tate National March of Dimes Representatives 2014 March for Babies Campaign The reasons we walk… In the United States, one (1) in nine (9) babies is born prematurely. Worldwide, 15 million babies are born too soon each year. More than 1 in 6 black infants are born premature compared to 1 in 9 for all babies. … thus, we are working to address the crisis at home and abroad.

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Page 1: 2014 - Zeta Phi Beta Sorority, · PDF fileSample Press Release ... 2013 March of Dimes Volunteer Leadership Conference Awards Luncheon Celebrity Emcee Niki Taylor ... 2014 and sport

Zeta Phi Beta Sorority, Inc. Mary Breaux Wright

24th International Grand Basileus

Rauchelle Jones National Director of Programs & Initiatives

Latasha Wilson Lane & Maryam J. Lynch-Tate National March of Dimes Representatives

2014 March for Babies Campaign

The reasons we walk… In the United States, one (1) in nine (9) babies is born prematurely. Worldwide, 15 million babies are born too soon each year. More than 1 in 6 black infants are born premature compared to 1 in 9 for all babies.

… thus, we are working to address the crisis at home and abroad.

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Zeta Phi Beta Sorority, Inc. 2014 March for Babies Campaign Toolkit 2 | P a g e

Our Success! ............................................................................................. 3

National Headlines .................................................................................... 4

Addressing Disparities ............................................................................... 5

What is March for Babies (M4B)? ................................................................ 6

Getting Started! ........................................................................................ 6

Ways to be involved with M4B ................................................................... 6

Become a Zeta Phi Beta MOD Representative! ............................................ 6

Raising Money and Reporting .................................................................... 7

Before the Walk ........................................................................................ 9

Fundraising Ideas .................................................................................... 11

During the Walk ...................................................................................... 12

After the Walk ........................................................................................ 12

Awards and Recognition .......................................................................... 13

Getting Z-HOPE Credit ............................................................................ 14

Sample Press Release .............................................................................. 15

Prepare for March for Babies 2015! ........................................................... 16

Notes ..................................................................................................... 16

Team Shirts Information and Order Form .................................................. 17

2013 March of Dimes Volunteer Leadership Conference Awards Luncheon Celebrity Emcee Niki Taylor – International Model and TV Host, Soror Maryam Lynch-Tate, Soror Rauchelle Jones, Grand Wright, Soror Latasha Wilson Lane, Soror Joanne McDougal Patterson, and Dr. LaVerne Council - Chair of the National

March of Dimes Board of Trustees

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Zeta Phi Beta Sorority, Inc. 2014 March for Babies Campaign Toolkit 3 | P a g e

Our Success! On behalf of our 24th International Grand Basileus, Mary B. Wright, we are launching our 2014 March for Babies (M4B) campaign. Many chapters have already begun their efforts to increase awareness of the March of Dimes (MOD) mission and raise funds for M4B and others are just getting started.

In 2013, Zeta Phi Beta and our auxiliaries raised $315,293! Our goal this year is to surpass that by raising $340K for Campaign 2014: “Joining Forces.”

Challenge

Regional Team Challenge - Recognize Regions who raise funds for M4B as a team that exceed $2,014 by December 1, 2014.

Team Shirts – Order your 2014 National Zeta, Amicae or Youth Group M4B shirts by March 3, 2014 and sport them at your local walk.

: “Blue & White Unite” Phamily Photo – In celebration of Phi Beta Sigma’s Centennial, take a family photo during your local M4B walk and email it to [email protected] by June 30, 2014.

We are commemorating the 42nd year of the Zeta Phi Beta and March of Dimes national partnership, thanks to our beloved Past International Grand Basileus Soror Janice G. Kissner, who is credited with linking the two organizations.

As THE signature walk event for Zeta Phi Beta, M4B participation offers more Z-HOPE points than any other walk!

As you peruse this toolkit, we hope that it helps you gear up for your local walk. We look forward to hearing about the great things that the members of Zeta chapters and auxiliaries do this year to help give babies a healthy start!

Soror/Friend Latasha Wilson Lane & Soror/Friend Maryam J. Lynch-Tate Zeta Phi Beta Sorority, Inc. National March of Dimes Representatives

Tash, Grand Wright & Maryam

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MARCH OF DIMES HIGHLIGHTS THE IMPORTANCE OF FOLIC ACID INTAKE FOR NATIONAL FOLIC ACID AWARENESS WEEK WHITE PLAINS, N.Y., JAN. 6, 2014 – Taking a daily multivitamin containing the B vitamin folic acid is one of the best ways to prevent birth defects and an important step toward having a healthy baby, yet only about one-third of women know about it.

National Headlines

PRESIDENT SIGNS PREEMIE REAUTHORIZATION ACT INTO LAW WASHINGTON, November 27, 2013— Today President Barack Obama signed into law S. 252, the PREEMIE Reauthorization Act, a bill to reauthorize federal research, education and intervention activities related to preterm birth and infant mortality. “The PREEMIE Act represents the federal government’s commitment to reducing the devastating toll of preterm birth,” stated Dr. Jennifer L. Howse, President of the March of Dimes. “By signing this bill into law, President Obama has enabled vital research and education on the prevention of prematurity to continue. The March of Dimes is deeply grateful to him, as well as the authors of the PREEMIE Act – Senators Lamar Alexander (R-TN) and Michael Bennet (D-CO) and Representatives Anna Eshoo (D-CA) and Leonard Lance (R-NJ) – for their tireless efforts to ensure that no baby is born too soon.

US PRETERM BIRTH RATE DROPS TO 15-YEAR LOW US Earns a “C” on the 2013 March of Dimes Premature Birth Report Card WHITE PLAINS, N.Y., Nov. 1, 2013 – The United States’ preterm birth rate dropped for the sixth consecutive year in 2012 to 11.5 percent, a 15-year low. Six states – Alaska, California, Maine, New Hampshire, Oregon and Vermont – earned an “A” on the March of Dimes 2013 Premature Birth Report Card as their preterm birth rates met the March of Dimes 9.6 percent goal. The US preterm birth rate improved to the lowest rate in 15 years, but the change wasn’t enough to earn it a better grade. The nation again earned a “C” on the Report Card. The March of Dimes estimated that, since 2006, about 176,000 fewer babies have been born too soon because of improvement in the preterm birth rate, potentially saving about $9 billion in health and societal costs.

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Addressing Disparities Babies born to black women in the US are more than 1 ½ times as likely to be born too early compared to babies born to white women.

More than 1 in 6 black infants are born premature compared to 1 in 9 for all babies.

In 2011 in the US, the preterm birth rate for black infants was 16.8 percent, compared to the national average of 11.7 percent.

Preterm by Race/Ethnicity

© 2009 March of Dimes Foundation All rights reserved

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What is March for Babies (M4B)? When we walk in M4B, we give hope to the more than half a million babies born to soon each year. The money we raise supports programs in our communities that help moms have healthy, full-term pregnancies, and it funds research to find answers to the problems that threaten our babies. MOD has been walking since 1970 and has raised an incredible $2 billion to benefit all babies.

Getting Started! Locate the MOD office closest to you, by logging onto www.marchofdimes.com/contactus/contactus.html

Click on your respective state (called MOD Chapters). Under Find More (right side), click Contact Us to find your local office. Each MOD office has its own web page. Also consider viewing the Local Grants link (if available) to learn about funds to conduct MOD mission programming.

In addition to location, you can also find out what activities are happening with MOD in your community.

Local MOD offices will also have resources and materials to use to raise funds and awareness including the M4B Team Captain Handbook.

To view a video that offers assistance on how to register for the walk and start raising funds, click here.

Ways to be involved with M4B Walk, raise money, volunteer at the walk site, serve on M4B logistics/planning committee, setup Stork’s Nest table/booth, make phone calls, assist with mailing or organizing at local MOD offices.

Become a Zeta Phi Beta MOD Representative! Interested in helping promote MOD to the Zeta Phi Beta family? There are multiple opportunities to volunteer and work with the National MOD Representatives in promoting the MOD mission. Send us an email to [email protected] and we can get you connected!

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Raising Money and Reporting

Benefits of Online Fundraising 1. It’s fun and easy! 2. Online users raise twice as

much money. 3. Helps track emails you’ve sent

and donations you’ve received. 4. Great tool for those

uncomfortable asking for donations.

Other Benefits Saves Time for Captains:

1. Track team’s progress anytime. 2. Less money to collect and turn in at Bank Day or March for

Babies Day. Easy for Walkers:

1. Sign-up online and print their own personalized sponsor form. 2. Track personal fundraising progress. 3. Store information from year to year. 4. Ask for money with emails. 5. Less money to keep track of and turn in at Bank Day or March

for Babies day. Easy for Donors:

1. Pay instantly with a credit card or PayPal. 2. Get a receipt from the March of Dimes confirming donation

right away. 3. Be confident March of Dimes has received donation.

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Online Fundraising and Reporting If you are planning to raise money using on-line fundraising (RECOMMENDED!), register at www.marchforbabies.org/zetaphibeta

From that site, select the state in which you reside. On the next page, select the March for Babies event/walk site where you plan to walk.

Enter the personal profile information and use the parent team name of Zeta Phi Beta. See nomenclature examples below. Zeta Regions: Zeta Phi Beta – Region Graduate Chapters: Zeta Phi Beta – Chapter Name Undergraduate Chapters: Zeta Phi Beta – Chapter Name – College/University Auxiliaries: Zeta Phi Beta - Zeta {Amicae, Achonettes, Amicettes, or Pearlettes} of City Name

Encourage your friends, family, co-workers, neighbors and places of worship members to participate in the campaign and become a member of your Zeta walk team. They should also register under the parent name of Zeta Phi Beta and the sub-team.

The system will walk you through how to create your own web page.

After you have successfully registered, the system will send you an automatically generated email with your own URL.

You can then send emails out to those in your email address book.

Online donations made to you can be in the form of credit card or electronic check.

For cash and checks you receive off-line/in-person, you can manually enter the amounts onto your web page so that the amount raised is reflected.

Cash and checks are then turned in to your local March of Dimes office either before or on the day of your M4B event.

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Zeta Phi Beta Sorority, Inc. 2014 March for Babies Campaign Toolkit 9 | P a g e

Traditional Fundraising and Reporting If you are planning to raise money the traditional way (i.e., writing letters and collecting from friends and family, etc.), contact your local March of Dimes to obtain an official sponsor envelope. The sponsor envelope will help you keep track of the donations received.

On the sponsor envelope, be sure to use the parent team name of Zeta Phi Beta as listed below:

Zeta Regions: Zeta Phi Beta – Region Graduate Chapters: Zeta Phi Beta – Chapter Name Undergraduate Chapters: Zeta Phi Beta – Chapter Name – College/University Auxiliaries: Zeta Phi Beta – Zeta {Amicae, Achonettes, Amicettes, or Pearlettes} of City Name

Your local March of Dimes can also share sample letters for your letter writing campaign.

You can use both online AND traditional ways to collect and report money raised.

Before the Walk Host events to raise awareness and money! Design a T-shirt or enter a Family Team poster! Honor mothers who have “Share Your Story” moments about prematurity.

Identify and recognize a Zeta Phi Beta Chapter Ambassador Family for March of Dimes or a Zeta Phi Beta Team Champion for March for Babies!

Invite others to support/join your team. Contact those who supported your chapter’s Zeta Prematurity Awareness Program (ZPAP) and ask them to participate.

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Team Shirts – Order your 2014 National Zeta, Amicae or Youth Group M4B shirts by March 3, 2014 and sport them at your local walk!

Shirt colors - Zeta: Royal Blue; Amicae: Light Blue; Youth: White (short sleeve and long sleeve available)

** Please refer to the Team Shirts Order Form at the end of this toolkit for more detailed information. **

Front of Shirt

Back of Shirt

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Fundraising Ideas In addition to asking individuals to sponsor you, there are other ways you and your chapter can raise funds for M4B. MOD offers a variety of items that can be purchased in quantities and sold for a small profit. The profit becomes a donation to the March of Dimes. Below is a list of fundraising ideas.

Ask your place of business to sponsor a ‘Blue Jeans for Babies’ event (donation to wear jeans) and donate the proceeds to your M4B fundraising campaign.

At meetings/conferences, leave a coin box in the center of every table. At some point, share the prematurity message and ask everyone to make a donation.

At chapter meetings, do a pocket change round-up and donate to M4B. Have a dance, step show or basketball game and donate the proceeds to M4B.

Sell stuffed animals! Check out www.calplush.com or www.plushland.com.

Host an event or meal function and donate a portion of the proceeds to M4B.

Additional MOD/M4B items for fundraising - www.awarenessproductsonline.com/marchofdimes.

Ask a local business/ company to collect coins from customers and donate to M4B .

Thank You!

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Zeta Phi Beta Sorority, Inc. 2014 March for Babies Campaign Toolkit 12 | P a g e

During the Walk Walk Day is THE most visible day for M4B supporters and families. As a national MOD partner, Zeta Phi Beta has been in the fore-front of walking, volunteering and raising money for MOD for many decades. Below are some activities that can be done to be visible at the walk sites.

Sorors, Amicae and Youth are encouraged to wear blue and white paraphernalia or their National M4B Team Shirts.

If possible, set up and staff a display table for Stork’s Nest to share information with walkers.

Lots of volunteers are needed on walk day. Event set up, food and beverage distribution, walk route monitors, merchandise sales, mission table, petition sign up, first aid, and cleanup are potential areas to volunteer.

Sponsor a rest station or mile marker along the walk route.

After the Walk You can still raise and report funds through September 1st. So if you have not reached your goal by Walk Day, you can still raise and report funds after the walk.

Submit the appropriate documentation to your State Z-HOPE Coordinator to receive your Z-HOPE points (if applicable)!

Email photos, stories and celebrations to

[email protected]

Send messages of appreciation to those who supported your efforts to raise money and awareness of prematurity and MOD.

Draft a press release and/or submit an article to your local media announcing your participation in M4B (see sample on page 15)!

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Awards and Recognition In 2013, Zeta Phi Beta and auxiliaries raised $315,293 winning the coveted “Zeta-Alpha March for Babies Challenge” and ranked as the #1 National Adult Service Partner in fundraising for MOD! Also, 17 chapters successfully completed

"Challenge " in 2013 raising $3,000 or more! We are proud of the efforts of those who are passionate to have happy and healthy babies and will be recognizing chapters for their fundraising efforts during the 2014 Boulé.

As we kick off Zeta’s Campaign 2014: “Joining Forces,” we look forward to hearing about the superaltives of chapters and auxiliaries across the globe supporting M4B!

International Grand Basileus Mary B. Wright delivers acceptance speech at the March of Dimes Volunteer Leadership Conference Awards Luncheon – October 2013.

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Getting Z-HOPE Credit

Z-HOPE for ALL - Walk or Run for a Z-HOPE™ Cause for

March of Dimes/March for Babies

In order to get chapter credit: {Graduate, Undergraduate, Amicae or Youth}

1. Minimum of 4 Zetas, Amicae, or Youth are required to participate in the event.

2. Minimum amount must be raised according to chapter size: Chapter/Auxiliary Size Required financial contribution amount for Z-Points

Up to 4 Members $ 200.00 (100 BONUS + 50 for every $500 over) 5-25 Members $ 500.00 (100 BONUS + 50 for every $500 over) 26-50 Members $ 700.00 (100 BONUS + 50 for every $500 over) Over 50 Members $ 1,500.00 (100 BONUS + 50 for every $500 over)

3. Activities must be verified by State Z-HOPE Coordinator.

4. To receive Z-Points, upon completion of the project, request a letter or report on letterhead from the Director of the organization detailing the amount raised and number of paid walkers. Attach a copy of the organization letter to the Z-HOPE Chapter Summary form, and complete the basic information on the form.

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Sample Press Release [PRINT ON CHAPTER LETTERHEAD]

FOR IMMEDIATE RELEASE: FOR INFORMATION, CONTACT (NAME, NUMBER AND EMAIL)

Zeta Phi Beta Sorority Supports March for Babies (CITY, STATE, DATE) —

Local chapters and auxiliaries of Zeta Phi Beta Sorority are once again supporting March for Babies by raising funds and awareness to prevent preterm birth and give more babies a healthy start in life.

Zeta members in more than 850 communities across America will participate in their local March for Babies walks. Throughout the year, members host fundraising events, register for Zeta Teams and serve as event volunteers.

Addressing preterm birth disparities, Zeta members and auxiliaries are at the forefront of raising awareness. Specifically, prematurity affects one out of nine babies born in the U.S. today—a rate that has increased 29 percent since 1981. The numbers are even more alarming for African-American babies who have a one-in-six chance of being born too soon.

In 2013, Zeta Phi Beta Sorority and auxiliaries raised more than $315,000 for March for Babies. This year, Zeta Phi Beta announced its Campaign 2014: “Joining Forces” to raise $340,000 to support the March of Dimes mission. “I am so excited about this year, and we can and will reach our goal,” states Zeta Phi Beta Sorority International President Mary Breaux Wright. “I am pleased about the interest across the sisterhood and look forward to a productive fundraising campaign.”

The March of Dimes is the leading nonprofit organization for pregnancy and baby health. With chapters nationwide and its premier event, March for Babies, the March of Dimes (MOD), founded in 1938, works to improve the health of babies by preventing birth defects, premature birth and infant mortality. Additionally, the March of Dimes, a national voluntary health agency whose mission is to improve the health of babies, funds programs of research, community services, education, and advocacy to save babies. For the latest resources and information, visit marchofdimes.com or its Spanish language website nacersano.org. Find MOD on Facebook and follow MOD on Twitter.

Zeta Phi Beta Sorority, Incorporated was founded in 1920 on the belief that the social nature of sorority life should not overshadow the real mission for progressive organizations to address societal mores, ills, prejudices, poverty, and health concerns of the day. The international organization’s 125,000+ initiated members, operating in more than 850 chapters, have given millions of voluntary hours to educate the public, provide scholarships, support organized charities, and promote legislation for social and civic change. For more information on Zeta Phi Beta Sorority, Inc., please visit www.zphib1920.org.

###

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Prepare for March for Babies 2015! In some communities, plans are already underway for March for Babies 2015! Yes 2015!

You can start planning for M4B 2015 by volunteering for the M4B planning committee or logistics team in your community.

Participate in the World Prematurity Campaign in November 2014 and raise funds by offering prematurity wrist bands for a donation.

Notes One Day… All Babies Will Be Born Healthy

Soror Janice G. Kissner with Elaine Whitelaw, National Director of Women’s Activities for March of Dimes – circa 1974

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Team Shirts Information and Order Form

As part of Zeta’s 2014 National March for Babies (M4B) Campaign–“Joining Forces”–we have partnered with The Exclusive Touch, LLC (a Zeta-registered vendor and active member of the Sorority) to offer team shirts that will show each Zeta-affiliated group’s pride and unified support of stronger, healthier babies at M4B events across the country. Please review the following instructions, use the attached order form, and place your team’s order by no later than Monday, March 3, 2014.

Orders may be placed via the following methods: 1. Mail: THE EXCLUSIVE TOUCH, LLC. PO BOX 2252, AKRON, OH 44309 2. E-Mail: [email protected] 3. Fax: 216-206-0396 4. Paypal: Please fax or email your order using the information listed. Indicate PAYPAL as

your payment choice so a PayPal invoice can be generated and emailed to you.

Payments will be accepted via chapter check, cashier’s check/money order, credit card (Visa, Mastercard, Discover, or American Express), or PayPal. All chapter checks must clear before orders will be processed. NO personal checks will be accepted under any circumstances.

Please make all chapter checks, cashier’s checks, and money orders payable to: THE EXCLUSIVE TOUCH.

The group order contact person will be notified of receipt of their order within 2 business days. Email confirmations will be sent with order and payment verification.

Orders must be placed/postmarked by no later than end of business on March 3, 2014. Orders will be produced and shipped out by/on April 1, 2014.

All orders will be shipped to the address on the original order form unless otherwise notified in writing. All packages will be shipped via USPS Priority Mail (2-3 business days transit time) for a flat rate fee of $9.95 per order.

Due to the anticipated high volume of orders, only chapter and/or group/auxiliary orders will be accepted (no individual orders please!!!).

All t-shirts are 6.1 oz 100% pre-shrunk cotton and are available in short sleeve and long sleeve styles. Adult shirts are available in sizes Small-6XL and the Youth shirts are available in Small-XL. Shirt sizes are unisex, so please base sizes from a standard men’s t-shirt.

Zeta Team Shirts: Royal Blue (Adult Sizes Only)

Amicae Team Shirts: Light Blue (Adult Sizes Only)

Youth Team Shirts: White (Youth and Adult Sizes Available)

A portion of the price from each shirt sold will be credited back to Zeta for our national fundraising efforts.

Please retain a copy of your order and payment method for your records.

If you have any questions regarding shirt orders, please contact The Exclusive Touch or let us know. Good luck fundraising!!! Sisterly,

Tash & Maryam

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The Exclusive Touch, LLC.  www.EXTouch.com  [email protected] 

The Exclusive Touch, LLC. PO BOX 225 

Akron, OH 44309‐2252 216.206.0351 (o) 216.206.0396 (f) 

[email protected] www.extouch.com 

Official 2014 Zeta Phi Beta Sorority, Inc.,  Zeta Amicae, and Zeta Youth Auxiliary  

March for Babies T‐Shirt 

 

Zeta Phi Beta Sorority, Inc. 

SHORT SLEEVE $15.00 each    LONG SLEEVE $20.00 SMALL    $    SMALL    $ MEDIUM    $    MEDIUM    $ LARGE    $    LARGE    $ XL    $    XL    $ 2XL (+$2.00)    $    2XL (+$2.00)    $ 3XL (+$3.00)    $    3XL (+$3.00)    $ 4XL (+4.00)    $    4XL (+4.00)    $ 5XL (+5.00)    $    5XL (+5.00)    $ 6XL(+6.00)    $    6XL(+6.00)    $ 

Totals    $    Totals    $  

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The Exclusive Touch, LLC.  www.EXTouch.com  [email protected] 

Zeta Amicae 

SHORT SLEEVE $15.00 each    LONG SLEEVE $20.00 SMALL    $    SMALL    $ MEDIUM    $    MEDIUM    $ LARGE    $    LARGE    $ XL    $    XL    $ 2XL (+$2.00)    $    2XL (+$2.00)    $ 3XL (+$3.00)    $    3XL (+$3.00)    $ 4XL (+4.00)    $    4XL (+4.00)    $ 5XL (+5.00)    $    5XL (+5.00)    $ 6XL(+6.00)    $    6XL(+6.00)    $ 

Totals    $    Totals    $ Zeta Youth Auxiliary Adult 

SHORT SLEEVE $15.00 each    LONG SLEEVE $20.00 SMALL    $    SMALL    $ MEDIUM    $    MEDIUM    $ LARGE    $    LARGE    $ XL    $    XL    $ 2XL (+$2.00)    $    2XL (+$2.00)    $ 3XL (+$3.00)    $    3XL (+$3.00)    $ 4XL (+4.00)    $    4XL (+4.00)    $ 5XL (+5.00)    $    5XL (+5.00)    $ 6XL(+6.00)    $    6XL(+6.00)    $ 

Totals    $    Totals    $ Zeta Youth Auxiliary Youth Sizes

SHORT SLEEVE $12.00 each    LONG SLEEVE $15.00 SMALL (6/8)    $    SMALL (6/8)    $ MEDIUM (10/12)    $    MEDIUM (10/12)    $ LARGE (12/14)    $    LARGE (12/14)    $ XL (18/20)    $    XL (18/20)    $ 

Totals    $    Totals    $ 

Total Short Sleeve    Total Long Sleeve ZETA    $    TOTAL    $ AMICAE    $    AMICAE    $ YOUTH (Adult)    $    YOUTH (Adult)    $ YOUTH (Youth)    $    YOUTH (Youth)    $ 

Totals    $    Long Sleeve Total    $         Short Sleeve Total    $         Shipping    $9.95         TOTAL DUE    $ 

Page 20: 2014 - Zeta Phi Beta Sorority, · PDF fileSample Press Release ... 2013 March of Dimes Volunteer Leadership Conference Awards Luncheon Celebrity Emcee Niki Taylor ... 2014 and sport

The Exclusive Touch, LLC.  www.EXTouch.com  [email protected] 

The Exclusive Touch, LLC.PO BOX 2252

Akron, OH 44309‐2252216.206.0351 (o)216.206.0396 (f)

[email protected]

Group Order

Customer Information Sheet

Chapter/Auxiliary Walk Date

Address (Shipping)

City State Zip

Contact Person Title (if applicable)

Email Phone Number ( )

Cardholder Name

Address (Billing)

City State Zip

Home Phone Number ( ) Alternate Phone Number ( )

Name (as it appears on card) Payment Type (please circle) VISA MASTERCARD AMEX DISC CASHIER’S CHECK/M.O/CHAPTER CHECK PAYPAL Credit Card Number CCV (3-Digit or 4-Digit) Exp. Date (MM/YYYY)

I, _____________________________________, DO HEREBY AUTHORIZE THE EXCLUSIVE TOUCH, LLC. TO CHARGE MY CREDIT CARD IN THE AMOUNT OF $_________. BY SIGNING, I AGREE TO THE TERMS OF THIS SALE. Production for all ordered items will not begin until payment has been processed and cleared. Payments will be processed immediately upon receipt. Production time for your order begins AFTER payment has been cleared. Cancellation requests will only be considered if production of the product has not begun. All cancellation requests must be telephoned in by the person who originated the order. All cancellation requests must confirmed by either email or fax. Return requests will ONLY be considered within five days of receipt of the order. Cancellation fees may apply at the discretion of The Exclusive Touch, LLC. Returns and exchanges will only be accepted if there is a manufacturer’s defect or an inaccuracy on the part of The Exclusive Touch in regards to the original order with proper authorization. We maintain the right to determine what is or is not a manufacturing defect. For our complete ordering terms and conditions, please visit http://www.extouch.com. Signature_______________________________________________________ Date__________________