Name:__________________________________________
Address:_________________________________________
City/State/Zip:_____________________________________
Phone: __________________________________________
Email: ___________________________________________
$______ enclosed for ______
Golden Star Ornament at $50 each
$______
enclosed for ______
Angel Ornament at $20 each
$______
enclosed for ______
Tree Lights at $10 each
q I would like to make a tax deductible donation to the MGH Storks
to
help support the Lactation Center of Marin General
Hospital.
Enclosed, please find my
donation of: $__________________
In Honor or Memory of:
Name:
________________________________________
Address:
______________________________________
______________________________________________
Please list additional
names and addresses on the back side of this paper.
q
Please send an
acknowledgement card to Honoree(s).
q
Yes!
I’d like to RSVP for the Open House on November
22nd at Noon. Please put us down for
______ adults and _____ children.
This is a free event.
Method of Payment for ornaments:
q
Check made payable to MGH Volunteers
q
Visa
q
Master Card
Credit Card#
_____________________________________
Exp. Date: ______________
Signature:
________________________________________
Please mail your registration
to:
Marin General Hospital
Volunteer Office - Holiday Trees
250
Bon Air Road
Greenbrae, CA 94904
Thank you for supporting our programs at
Marin General Hospital!
100% of all donations go directly to support our programs at Marin General!
