Glide Wildflower Show 2011
"Building for the Future"


Thank you for helping us build


Donor Name: _____________________________________________________________________________
                             name as written here will be used for recognition in printed material

Address:  ________________________________________________________________________________


Home/Cell/Bus. Phone:  _______________   Email: _______________________________________________


Amount _____________________________ (any amount is welcome . . . thank you)

please make checks out to:                               Please charge my:      VISA ______    MC  _______
Glide Wildflower Show, Inc.
                                                                          acct. #  ______________________________ Exp. Date ________


                                                                          Billing Address: ____________________________________________


                                                                          Signature:  ___________________________________________




Mail to:                    Glide Wildflower Show Building Fund
                            P.O. Box 332
                            Glide, OR  97443