Print out and mail this form with your check to:

Furthe Shore, Inc.
P.O. Box 23518
Flagstaff, AZ 86002

Name: __________________________________________________________

Address: _______________________________________________________

City/State: ____________________________________________________

Zip code: ______________________________________________________

Email: _________________________________________________________

I would like to post my donation in Further Shore’s Dedication Garden. My donation is in loving memory of ________________________________________________.

I am making a donation in the amount of:
Sponsor - $25
Caring Sponsor - $50
Helpful Sponsor - $125
Supportive Sponsor - $250
Compassionate Sponsor - $375
Generous Sponsor - $500
Benefactor - $2000+
Other: $__________

I want to receive the newsletter:
via email
via post