Smiles for NFED Golf Tournament Formerly: Pacific NW Dental Conference Tournament Dan Petersen, DDS, Chairman To benefit the National Foundation for Ectodermal Dysplasias Last Update: 07-05-1999 Back to Home Page

DONATION FORM - Cannot Attend
Please print or type.

I cannot participate in the tournament, but please accept my tax-deductible contribution to support the NFED.

Name________________________________ Company___________________________________ Address____________________________________ City______________________ST____Zip________ Phone(home)_______________(work)___________ FAX_____________________e-mail_____________		Donation - Check or Credit Card *donations are tax deductible regardless of participation (Tax ID# 37-1112496). ___ My check for $ __________, payable to NFED is enclosed. ___ I would like to charge $ __________ to my       ___MasterCard       ___VISA Card #________________________________________________ Expiration Date:______________________________________ Name on card (print): ______________________________________________________ Cardholder Signature: ______________________________________________________

Return to: Betsy Howe / NFED P.O. Box 2069 Auburn, WA 98071-2069 Phone/FAX 253-735-5195 nfed3@aol.com

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