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4S Livestock Shinkewski |
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GM Ranch |
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Shaefer |
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Convinced? Print out and fax or mail the form below with your payment today! Don't miss a chance to become a part of Museum history! |
Print, clip and fax or mail with your payment ......
| Name: | Address: |
| City: | Province/State |
| Country: | Postal Code/Zip Code: |
| email: | Phone Number: ( ) |
| NAME(S) TO APPEAR ON PLAQUE: | |
| 1/ | 2/ |
| 3/ | 4/ |
| Method of Payment: (All payments in Canadian Dollars please. Do not send cash) | |
| Number of Squares: ______@$20.each Total = $ _______ | [ ] Check [ ] VISA [ ] MasterCard |
| Card Number: | Expiry Date: |
| Signature: | Name on Card: |