Foundation GIFT
As a special way of caring, enclosed is my gift of:
| ___$10 | ___$25 | __$50 |
| ___$75 | ___$100 | __$250 |
| ___$500 | ___$1,000 | ___other ______ |
From ___________________________________________
Address__________________________________________
City _____________________________________________
State ________________Zip ___________
In memory of ~ In honor of ~
Please inform _____________________________________
Of this gift (amount not disclosed)
Address__________________________________________
City _____________________________________________
State _________________ Zip ___________
Please return this form with your donation and mail to:
Logan Medical Center Foundation
P. O. Box 1017
Guthrie, OK 73044
405-260-4377
All gifts are tax deductible to the fullest extent of the law. |
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