Nursery Notes Nov-Dec 2011 - The Paginator
Nursery Notes Nov-Dec 2011 - The Paginator
Nursery Notes Nov-Dec 2011 - The Paginator
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<strong>2011</strong> Green Industry Council<br />
PAC Fundraiser Contribution Form<br />
(Please fill out all requested information)<br />
Name: __________________________________________________________________<br />
*Spouse Name: ____________________________________________________<br />
Job Title/Profession: _______________________________________________________<br />
Employer’s Name/Specific Field: ___________________________________________________________<br />
Member of which trade association(s): _______________________________________________________<br />
Home Address: ___________________________________________________ State: ____ Zip :__________<br />
Phone: (______)_____________ Email: _______________________________________<br />
___$150.00 per couple* ___$100.00 individual ___Other amount $_______<br />
___ VISA ____ MasterCard<br />
Credit Card # _____________________________________________________<br />
Billing Address: ___________________________________________________ State: ____ Zip: __________<br />
Security Code: ________ Signature: _______________________________________<br />
(3 or 4 digit code on back of card)<br />
mail to:<br />
Contributions must be personal check or personal credit card only.<br />
No cash will be accepted<br />
Make your personal check payable to: NCGIC PAC<br />
40 • <strong>Nursery</strong> <strong>Notes</strong><br />
NC GIC PAC<br />
3901 Barrett Dr., Ste 202 ~ *or ~ mail@ncgreenindustrycouncil.com<br />
Raleigh, NC 27609 FAX: 919.782.9470
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