
Name: |
|
Address: |
City, State, & Zip: |
Memorial or Honor Name: |
Next of Kin Name: |
Acknowledgement Address: |
City, State, & Zip: |
Dear Fr. John: |
||
$500 |
$50 |
|
$250 |
$25 |
|
$100 |
Other: |
|
Please make checks payable to:
SOME
71 "O" Street, NW
Washington, D.C. 20001
-- OR --
Please bill my credit card:
Visa Mastercard Discover (Novus)
Account No.: |
Expiration Date (MM/YY): |
Signature: |
|
Please fill this out, then print and mail to the address listed above.
Thank You!