Thank you for supporting MASH! You may print this form and mail it to the address below. If your gift is in honor or memory of a loved one, please complete the information at the bottom of the form. My tax-deductible contribution is: $____________ ___ Please accept the enclosed check payable to MASH ___ Please accept my/our pledge of __________________ to be paid by June 30 ___ My/Our company will match my gift. I have enclosed the appropriate form. Name _________________________________________________________ Address _______________________________________________________ City _________________________________ State _____ Zip ___________ Home Phone _____________________ Business Phone ________________ ___ My gift is in honor or in memory of (please circle one): _________________________________________________________ Please send an additional acknowledgement of this gift to: Name _________________________________________________________ Address _______________________________________________________ City _________________________________ State _____ Zip ___________ Please mail the completed form to: MASH 119 High Street Mystic, CT 06355

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