Origami Butterfly Ornament |
BUTTERFLY ORDER
PLEASE PRINT FORM & MAIL TO ADDRESS BELOW
Please place a butterfly on the "Our Children Lovingly Remembered Tree"
to honor the life of:
Child's Name (please print) ________________________________________________
Child's Birth Date: _____/_____/_____ Child's Anniversary Date: _____/_____/_____
Your Name:_____________________________________________________________
Address:________________________________________________________________
City:____________________________State:_______________Zip_________________
Phone:______________________Email:_______________________________________
1st Color Choice:_____________________ 2nd Color Choice______________________
Enclosed is my tax deductible donation of: $_________ ($5-$10 suggested donation)
VISA _____ MC_____ AMEX_____ Card # _ _ _ _ -_ _ _ _ - _ _ _ _ - _ _ _ _
CVC # (on back of card) _ _ _ Expiration _________ Zip _____________
Mail to: The Compassionate Friends / Origami P.O. Box 3065 Portland, OR 97208-3065