RELAY FOR LIFE OF GUAM 2015
LUMINARIA ORDER FORM
Each year at the American Cancer Society’s Relay For Life, we light thousands of luminaria bags around
the world as a special tribute to those who are fighting cancer, those we have lost, and the many
friends and family members who represent victory over the disease.
Your Name:
Team Name:
Phone #:
Email:
 Luminaria Only ($12 minimum)
 Luminaria and Dedication in Booklet ($22)
Bag number: _________________________
 I will decorate my Luminaria bag
DEADLINE to Submit Decorated Luminaria Bags: May 14, 2015
 I want ACS to prepare my Luminaria Bag. Please decorate as described below:
Dedicated By:


In Honor Of:
In Memory Of:
Make check payable to AMERICAN CANCER SOCIETY  Deliver Form to: Guam Field Office, 479 West O’Brien Drive, Suite 102, Hagatna, GU 96910  477-9451
ACS Office/Volunteer Use Only
 Cash  Check #:
Amt PD:
Form Accepted By:
Date Created/Submitted:
Note: Luminaria will be available at the event for $20, (while supplies last)
LUMINARIA BOOKLET DEDICATION INSTRUCTIONS
Color Photo Here
DEDICATED TO:
Message:
1. Dedication (quarter page size) can only be purchased
in addition to a luminaria. (Not available separately).
2. Submit all orders to the ACS Office (Bank of Guam,
Santa Cruz Branch in Hagåtña) between 9:00 AM to
4:00 PM, Monday to Friday. If you are submitting a
dedication to a Team Captain, please ensure that they
turn in the dedication by the deadline. Note that ACS
Office Staff will not be responsible for dedications not
submitted on time.
3. Deadline to submit ALL dedications is TUESDAY
APRIL 14, 2015. NO EXCEPTIONS. This deadline is
necessary to ensure booklets are produced and printed
in time for Relay For Life Event, May 22, 2015.
4. Keep in mind dedications will be scanned into the
booklet. Therefore, all decorations for the dedication
must be smooth and flat and stay within the box to the
left.
5. Dedications will not be returned. Therefore, copies of
color photos are encouraged (no originals, please).
From: