Origami Butterfly Ornament

Butterfly Order

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:_______________________________________
 
Enclosed is my tax deductible donation of: $_________ ($5-$10 suggested donation) 
 
VISA _____     MC_____     AMEX_____     Card # _ _ _ _ -_ _ _ _ - _ _ _ _ - _ _ _ _
 
CVC # (on back of card) _ _ _     Expiration _________ 
 
 
Mail to: The Compassionate Friends / Origami   P.O. Box 3065   Portland, OR 97208-3065