Count me as a Friend!

Print and fill out, or copy and paste into an email address:

Name: ______________________________________________ Date: _______________

Address: _________________________________________________________________

City: _________________________________ State: ________________ ZIP: _____

Phone: _____________________ E-mail: _____________________________________

[ ] Student $10                         Make checks payable to: FMCWR

[ ] Individual $15                      Mail to:    FMCWR        
                                                    P.O. Box 471      
[ ] Family $30                                      Burbank WA 99323-0471
                                               
[ ] Organization $50                    Email to: mcnaryedcenter@gmail.com   

[ ] I'd like to make a donation of $ _______