Print out and mail this form with your check to:
Further Shore, Inc.
P.O. Box 23518
Flagstaff, AZ 86002
Name: __________________________________________________________
Address: _______________________________________________________
City/State: ____________________________________________________
Zip code: ______________________________________________________
Email: _________________________________________________________
My donation is in loving memory of ________________________________________________.
I am making a donation in the amount of:
Friend – $25
Caring Friend – $50
Helpful Friend – $120
Supportive Friend – $240
Compassionate Friend – $375
Generous Friend – $500
Benefactor – $1,000
Other: $__________