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I want to help by calling 1-800-350-CURE or completing this form

Please accept my enclosed gift by check of $____________ to help Find-a-Cure get this job done.

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Please charge my credit card $____________

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Expiration Date	_____________________________________
Signature	_____________________________________
Name (Print)	_____________________________________
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Telephone No	_____________________________________
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E-Mail Address	_____________________________________

My employer may be able to match this gift, please contact:

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I know of a friend or gorup that may want to help you:

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Send in this form and mail along with your tax deductable donation made payable to:

Find-A-Cure
for Children with Duchenne, Inc.
39 Lake Ave. P.O. Box 33
Island Heights, N.J. 08732-0033

THANK YOU!