Please provide the name of the person in who you are honoring by making the memorial contribution:

_______________________________________________

Name of honoree

Please give the Name and address of the person(s) you would like the Foundation to send the Memorial Card to:

Name ___________________________

Address_________________________________

City ___________________ State______________ Zip_______________

Amount of contribution: $__________________

Send to :

Texas-Oklahoma Kiwanis Foundation
624 Six Flags Drive, Suite 265
Arlington, Texas 76011-6342