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CKRM Musical Christmas Card for MS -D Dedication and Song Request Form Donor s/Requester s Name City/Town of Donor/Requester Dedication to City/Town of dedication recipient Song Request Pledge Amount Phone Address Postal Code Please circle Method of Payment CASH CHEQUE CREDIT CARD The MS Society will call you to process this payment over the phone please be sure to include your phone number Mail pledge to MS Society 150 Albert Street Regina SK S4R 2N2.

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01

To fill out the donor's/requester's name, start by writing the full name of the person or organization who is requesting or donating.

02

Next, fill in the city/town where the donor/requester is located. Write the complete name of the city or town.

03

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