(Please print this page, complete the
information requested, and mail this page with your cheque to the address noted below:)
I, _____________________________ wish
to donate $ _________ to:
Tick one box:
| RR Smith Capital Fund | |
| RR Smith Disbursement Account |
Mail to:
|
100 - 550 W. 6th Ave., Vancouver, BC V5Z 4P2 Tel: (604) 871 - 2260
|