Please print this page and mail with your check (made payable to Midwestern Braille Volunteers) to:

 

Midwestern Braille Volunteers

104 W Adams Ave

Kirkwood, MO    63122

 

This donation, in the amount of $_________.____ is for general operating funds or

In Memory of ______________________________________________________

In Honor  of   ______________________________________________________

 

Please send an acknowledgement of my gift to:

Name           _______________________________________________________

Address       _______________________________________________________

City/State/Zip  _____________________________________________________

 

Please send a gift receipt to me at:

Name           _______________________________________________________

Address       _______________________________________________________

City/State/Zip  _____________________________________________________

email address _____________________________________________________

 

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