DONATION FORM FOR THE MARRIAGE BED, INC.
All information is optional, but we need a name and address if you wish to receive a year end donation confirmation for your taxes.
City: __________________________ State: ____________
Zip/Postal Code: ________ Country: __________________
Amount enclosed: $ _______
One time gift ___ Recurring gift ___
E-mail address ___________________________________
__ Check here to receive confirmation by e-mail.
__ Check here if you do NOT want a donation confirmation - no mail will be sent.
The Marriage Bed, Inc.
4641 Lyons Hill Road
Springdale, WA 99173