Every dollar gives more promise!
Donate today.
Life is a gift to all of us, 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.
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 Thesis Papers | [__] | _______ | ||
| 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 Dr. Dan Mustaine
[_] Traveler's Check [_] Cashier's Check [_] Money Order
Payable to: Dr. Dan Mustaine
Mail Completed form with Payment to USA:
Dr. Dan Mustaine
221 W. Court St. #5
Urbana, OH 43078