Yes, I want to be a Contributor

Please accept my contribution of:   ___ $25     ___ $50     ____ $100     ___ $500     ___ Other
I am willing to contribute:            ______Time   ______Supplys   _____Services

Comments:  __________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

Contributions are tax deductible and Greatly Appreciated.

Name:  ___________________________________________________________________________________

Address: _____________________________________  City __________________  State _____  Zip ________

Telephone:  ___________________________________   Email:  ______________________________________

Print out form and mail to:   Lee Mission Cemetery, PO Box 2011, Salem, OR 97308