Please print this form, fill it, attach your check* and mail it to:

Armenian Relief Society of Eastern USA, Inc.
Centennial Celebration Committee
80 Bigelow Avenue
Suite 200
Watertown, MA 02472

*Please make checks payable to the Armenian Relief Society of Eastern USA, Inc.

(35 articles will be reprinted in ad book, 35 page sponsors for each Of these articles)

Leadership Donor $5,000
Agnouni Circle $1,910
Gold Page $1,000
Silver Page $500
Half Page $150
Quarter Page $75
Page Sponsor $100

MEMORIAL:

In memory of : _____________________________________

City, State:________________________________________

HONORARIUM:

Gift in honor of:_____________________________________

Honoree’s Address:__________________________________

City, State, Zip:_____________________________________

DONOR INFORMATION:

Donor Name:________________________-______________

Address:__________________________________________

City, State, Zip:_________________-___________________

Telephone:_______________ Email:_______-____________

PAGE SETUP:

© 2001-2008 ARS of Eastern United States, Inc. All rights reserved.