Please fill out the form below and place it in the box with your phone(s).
Make check payable to:
First Name				Last Name
Address
City, ST						Zipcode
Number of phones:
OR:
You can donate the money to your favorite charity.  If you would like a
receipt for tax purposes, please also fill in the above information.
Charity Organization
Address
City, ST						Zipcode
Donated by:
For Office Use Only:
Quantity				Received
Amount				Sent