Douglas County Memorial of Honor Foundation

CONTRIBUTION FORM

To recognize those who have died in service to our community and country, I (we) pledge:

$_____________     (   ) Payment in full is enclosed

                                 (   ) Pledge to be paid as follows:

Signature(s)    ________________________________________________________________

Name(s)        ________________________________________________________________

Address        ________________________________________________________________

City              ______________________________  State __________  Zip Code __________

Make checks payable to Douglas County Memorial of Honor Foundation

DINNER RESERVATION FORM

Yes, please make _____ reservations for me and my guests. (Spouse and other guests are welcome.)

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.

For those few who have not already paid your 2003 dues,
please include your check for $15.00

TEAR OFF AND RETURN THIS FORM WITH A CHECK PAYABLE TO:

JAYHAWK CHAPTER MOAA