Please print off this form and return it to:

38292 Deer St.
Aitkin, Minnesota 56431

Mr. Ms.
Mr. & Mrs. _____________________________________
Address __________________________________________
              __________________________________________
Phone ____________________________________________

CHOOSE A LEVEL OF SUPPORT

Golderrod.....................?
Crimson................$30.00
Sienna...................$20.00
Amber...................$15.00

Your comments and suggestions: ________________________ ____________________________________________________ ____________________________________________________
____________________________________________________ ____________________________________________________

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