Jennings Randolph Recognition Project Contribution Form

JENNINGS RANDOLPH RECOGNITION PROJECT

Contribution Form

Yes! I would like to support the Jennings Randolph Recognition Project
to memorialize the contributions of the Mountain State Senator
whose values inspired the world.

*Organization*:	____________________________________________________________

*Your Name*:	____________________________________________________________

*Title*:	____________________________________________________________


Address:	____________________________________________________________

*City/State/ZIP*:	____________________________________________________________

	____________________________________________________________

Telephone:	____________________________________________________________

*Fax*:	____________________________________________________________

E-mail:	____________________________________________________________

*Signature*:	____________________________________________________________

Enclosed is my gift of:

$50

$100

$200

$500

Other ______

Donations to the Jennings Randolph Recognition Project (JRRP)

are tax-deductible under IRS Code 501 (c)(3) with checks payable to:

The Agribusiness Council - JRRP
P.O. Box 5565
Washington,DC 20016

Thank You!

"Building bridges through associations with peoples of the world"

Randolph Recognition Project

Application Form

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