Name:__________________________________
Address:_______________________________
City:__________________State:__________
Zip + 4 (save us postage!):____________
Phone #:(______)_________-_____________
e-mail addr:___________________________
___ Student $15.00
_______________________(name of school)
___ Individual $20.00
___ Family $30.00
___ (number in family)
Total: $______
Please return this form with payment to:
Internet E-mail: mnsfs@mnsfs.org
Last rev:
November 9, 2005 -
dlb & rab