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Committee Member: ______________________________________
Sponsor's Name: _________________________________________
Street Address: ___________________________________________
City: ____________________State: ___________ Zip ____________

Signature: _______________________________________________

All checks and this form must be received by May 9, 2008.
Mail to: PO Box 704 , Maple Shade , NJ 08052
Electronic files may be sent to mclefac@aol.com or call Lisa at 609-335-1130

The Foundation is registered to participate in the Combined Federal Campaigns (CFC #10507). It is also an Internal Revenue Service 501 © 3 Tax-Exempt Charity, Federal Tax ID # 22-3357410