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Jailbird Fast Fax Form To: all my friends From: Rick Barnhouse I am going to jail… and I must raise my bail to get out! I will be locked up on June 13th from 11:00 a.m. to 12:00 p.m. at the Simon B’s restaurant in Bolivar Missouri as part of a fundraiser for the Muscular Dystrophy Association. My bail has been set at $500! Conducting business from a jail cell will be challenging. Won’t you help free me? Donations are being accepted. Please fill out this donation form and fax it back to me at 417-777-8519 or just reply to this email with the pertinent information. MDA will bill you (or send a receipt if you use a credit card). You can even mail me a check if you wish (made out to MDA) and I will fill out the paperwork for you. My address is 4618 S. 156 Rd. Bolivar, MO 65613. Thanks for any help you can offer! Yes! I’ll help get you out of "jail"! I wish to donate $____________. Please have MDA office ___ bill me direct or ___ bill my credit card. _ Visa _ MasterCard Card # __________________________ Exp. Date __________ _ American Express _ Discover Please send a bill/receipt to the address below: Name: ______________________________________ Company: _____________________________________ Address: ________________________________________________ City: _________________________________ State: _________ Zip: ______________ Day Phone Number: (_____)_________________________ If I may be so bold as to suggest an amount, maybe $25 for individuals and $100 for companies. Thanks a bunch! Rick Barnhouse |
