Life is a gift, and all of us who have the ability must remember that we have the responsibility to give something back. Your contributions can truly make a difference. Thank you for your tax deductible donation.
ONLINEDICE DONATION FORM (Fill out form completely)
| Name:_______________________________ | Title:______________________________ |
| Address:____________________________ | City:_______________________________ |
| State/Province:_____________________ | Zip/Post Code:______________________ |
| Country:____________________________ | Date:_____/_____/_____ |
| Email Address:______________________ | Signature:__________________________ |
Comments:
| Cause | Total | |||
| Online Dice Role-playing Dice Site | [__] | _______ | ||
| Online Dice Romance Dice Site | [__] | _______ | ||
| Total Enclosed | _______ | |||
note: comments may be used to fortify our offering and hereby become the property of Dan Mustaine
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Payable to: Dan Mustaine
Mail Completed form with Payment to USA:
Dan Mustaine
537A Mapletree Ln.
Urbana, OH 43078