Please Print this
Donation Form, Fill it Out, and Mail it
to:
( or Simply Send Information with Payment)
SELF Expressions Unlimited
P.O. Box 659
Cairo, Illinois 62914
Society of SEU,
Enclosed is My
Generous Contribution to SELF Expressions Unlimited.
I Know My Contributions are Very Much Needed and Appreciated!
Amount Enclosed:
□
$1
□
$5
□
$10
□
$20
□
______
Suggested Contribution: $10.00 (U.S. Currency)
(Make Check or
Money Order Payable to SELF Expressions Unlimited)
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- All Fields are
Optional -
Date of
Contribution: ________________________
Name or
User Name:
________________________________________
City or
Location: ____________________________________________
State: ____________________ Country: _________________________
Zip Code:
_____________ Area Code: ___________
E-Mail Address:
_____________________________________________
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S
E
U
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Thank you very much for
Contribution to The SEU Society.
Monetary Contributions to SELF
Expressions Unlimited are Not Tax-Deductible for Federal Income Tax
Purposes
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