DONATION

q Yes, you can count on me!

Please accept my gift of: $54 $55 $56 $57 $58 $59

OR

$10 $15 $20 Other $____________

Check or Money Orders are Acceptable

q Please apply my donation to:

q Education Scholarships

q Brain Cancer Research

q Housing

q Foundation Choice

q Yearly Contribution (Yes, you can count on me for a yearly contribution.)

---------------------------------------Cut on line and mail top portion back------------------------------------

A receipt for contribution will be sent to you. Make checks payable to the “Sally Foundation” and send to:

Al Horcasitas

1722 W. Southfork Dr.

Phoenix, AZ 85045

Home Phone: 480-460-1120

Cell Phone: 480-415-1193

The Sally Foundation is a non-profit organization Copyright© 2006 All Rights Reserved