Print this
form and mail to:
Frances
Hoffman,
1499 Jigs Hollow Road,
R. R. 2,
West Montrose,
Ontario,
CANADA,
NOB 2VO
Donor
Information
Name
of Donor: _______________________________________
Address: ____________________________________________
Telephone: ___________________________________________
Email: _______________________________________________
Photo Information:
Name(s) of Subject: _____________________________________
Date of Photograph: _____________________________________
Photographer's Name: ___________________________________
Where photo was taken: _________________________________
Size of Photo (cm): _____________________________________
Additional Information: __________________________________
______________________________________________________
______________________________________________________
______________________________________________________
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