The Rogallo Foundation

ROGALLO FOUNDATION MEMBERSHIP FORM

Please print out this form and mail it to us along with your tax free contribution.

Yes! I want to help protect and preserve the legacy of free flight.
My Special Gift is: [ ] $25 [ ] $50 [ ] $100 [ ] $500 [ ] $1,000 [ ] $2,000
Rogallo Wings for the World poster [ ] $40
Name	__________________________________________
Address	__________________________________________
State	__________________________________________
Zip Code	__________________________________________
Country	__________________________________________
[ ] Master Card [ ] Visa # _____________________________ Expiration Date _______
Signature: __________________________