Your Name_____________________
Your Address____________________
Your Best Phone _________________
Your email______________________
Mothers Name___________________ living yes no
Fathers Name___________________ living yes no
Listing of name $25. contribution
Written Tribute $35. contribution
(50 words or less)
Written Tribue with photo $50. contribution
(50 words or less)
Go to Democrathens.com for more information. You may pay by credit Visa or MasterCard online at our web address. Make checks payable to ACDP and mail to P.O. Box 191, Athens, Ohio 45701. You may also email info to susan@gwinnlaw.com
Deadline is Wednesday before Mother’s Day and Father’s Day