| Glide Wildflower Show
2008 "Building for the Future" Thank you for helping us "bloom" |
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 2008 1224 N.E. Walnut #800 Roseburg, OR 97470 |