Donate to the Double Angel Foundation |
|
Name | _____________________________________________________________ |
Address 1 | _____________________________________________________________ |
Address 2 | _____________________________________________________________ |
City | _____________________________________________________________ |
State | _____________________________________________________________ |
Zip Code | _____________________________________________________________ |
Daytime Phone | _____________________________________________________________ |
_____________________________________________________________ | |
Mailing List | Yes, please put me on e-mail list No, thank you |
Payment Method | American
Express Discover Master Card Visa |
Amount | $25 $50 $75 $100 $150 $250 $500 Other $______ |
Credit Card # | _____________________________________________________________ |
Expiration Date | _____________________________________________________________ |
Signature | _____________________________________________________________ |
Please Print,
then Mail to: |
The
Double Angel Foundation P.O. Box 4004 Parker, CO 80134 |