YOU CAN COUNT ON ME FOR A ONE TIME DONATION OF: _____$5 _____$10 _____$15 _____$25 _____$50 _____ $100 other$________ YOU CAN COUNT ON ME FOR A MONTHLY DONATION OF: _____$5 _____$10 _____$15 _____$25 _____$50 _____ $100 other$________ Name______________________Email_____________@_______________________ Address: ____________________ ____________ ____________ city State zip Code Phone: ___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___ Endorsed by Judge Ray Holbrook, the Texas Judge who implemented the Galveston retirement plan Make checks Payable to: Americaretoday Mail To: 10496 S Walden Forest Circle – Homosassa, FL 34446 Funds will be deposited in: Florida Traditions Bank 4301 Barclay Ave. - Spring Hill, Fl 34609 Copyright AmeriCareToday 2012 You may contact Jim at: JG@americaretoday.com Or 352.503.9229 AN ORGANIZATION THAT WILL SPEAK UP ON YOUR BEHALF