Drug Awareness Donation

Donation Amount: _____________

(Minimum of $3.00 donation)

Donor Name: __________Club # ___

Please print this form, fill it out and mail it according to the instructions below

Happy Birthday ____

Anniversary ______

In Honor Of: ______

In Memory of: _____

Thinking of You: ____

Congratulations: _____

Recipient: __________________________

Address: ___________________________

City: ___________ State: _____ Zip: ____

 

Please type or print clearly:

 Send To: PSP Mona Vandever
               3315 S. Eastern Ave.
               Las Vegas, NV 89109

Make Checks Payable to: Drug Awareness Fund

Your canceled check is your receipt.

Please print this form, fill it out and mail it according to the instructions below