Name of Donor: ________________________________________________________

Street Address:_________________________________________________________

City/Town:______________________________________________________________

State:________________________________ Zip Code:_______________-__________

Amount Inclosed $ ____________________

Please make checks payable to:     US Submarine Veterans' Charitable Foundation

Note in the memo portion of the check:    Library Fund

Mail To:

USSVCF- Library Fund
P.O. BOX 3870
Silverdale, WA 98383-3870

Please include this form with your donation.
Thank you for your interest and support of this program.

CFL-2 (2002)