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Crop for Autism 2011
Saturday, March 12th
9am- 9pm
St. Joseph By The Sea High School
5150 Hylan Blvd.
SI, NY 10312
$65.00 per person
Registration Form
Name: __________________________________________________
Address:_________________________________________________
City, State & Zip:___________________________________________
Home & Cell Phone:__________________________________________
Email:____________________________________________________
3 ways to Pay!:
Check one:
___Personal Check (payable to the Grace Foundation of NY)
Mail payment and registration form to:
Crop for Autism
Grace Foundation Of NY
264 Watchogue Road, Staten Island, NY 10314
___Paypal Visit our Blog at the Grace Foundation Website at
www.graceofny.org and use the paypal link and mail registration form to:
The Grace Foundation
264 Watchogue Road, Staten Island, NY 10314
or email to graceofny@aol.com
___Credit Cards Amercian Express, Mastercard or Visa
(fill out & sign below) Mail registration form to:
The Grace Foundation
264 Watchogue Road, Staten Island, NY 10314
or email to graceofny@aol.com
Credit card #: ___________________________
Exp. Date: _________ Amt. Paid: ___________
Signature: __________________________ Billing address Zip Code: ____________
Please list names of ALL croppers you want to sit with, Max. 6 croppers per table:
Receive a complimentary raffle ticket for each donation of supplies or food.
My donation is: (circle one): Snacks, soda bottles/cans, water bottles, cookies, cake, wrapped candy, scrapbook supplies for garage sale table! Other donations:__________________________
Check out our blog at www.gracecropforautism.blogspot.com
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