Manned Amateur Radio Experiment MG Corp.
3 Moccasin Lane
Chelmsford Massachusetts 01824 USA
marexmg@comcast.net
To: MAREX MG
Please accept this donation to MAREX MG for supporting existing and future Educational Amateur Radio Space projects. I understand that I may make the donation by check.
Name: _________________________________________ Call Sign:____________
Address: ____________________________________________________________
City: __________________________ State / Province: ________
ZIP/Post code: _______________ e-mail address: ________________________
Please make check payable to MAREX MG
Check Amount: ______________________________ Number: ____________
Daytime Telephone Number _____________________________ (optional)
Signature: ________________________________________ Date: ___________
2003.07.11