Douglas County Memorial of Honor Foundation |
$_____________ ( ) Payment in full is enclosed
( ) Pledge to be paid as follows:
Signature(s)
________________________________________________________________
Name(s) ________________________________________________________________
Address ________________________________________________________________
City
______________________________ State __________ Zip Code __________
The cost is $18.00 per meal. I am enclosing a check for $__________ for
meal(s).
Name ______________________________________
Telephone ______________
You may use the reverse of this form to provide information for
change of address, Newsletter items, requests for help, etc.
JAYHAWK CHAPTER MOAA