According
to the American Heart Association, each year 40,000 babies are born with
a congenital heart defect (CHD) in the U.S. alone. An estimated
1 million
Americans are living with a CHD today. The research being done and the technology
available to treat CHDs is critical in
helping a new baby, child, or adult
living with CHD—today!!
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Yes, I would like to order a
CD!
Quantity ___________ @ $5.00 each = Amount $___________
$3 goes to CHD causes
¨
Yes, I would like to order a
custom “Mending Hearts” quilt!
Quantity ___________ @ $30.00 each = Amount $___________
Custom Embroidery Information (PLEASE PRINT CLEARLY!)
[Include gender
(boy/girl), child’s name, abbreviations of defects, date of birth, and date
of death (if applicable)]
Use back of page for additional quilts if necessary.
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
For
CDs or quilts, please provide a name and shipping address:
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
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Yes, I would like to make a
donation to The Justin Dunn Congenital Heart Foundation!
Amount $___________
Add
Shipping, if applicable:
$0 to 9.99 = $2.00 Subtotal $___________
$10
to 49.99 = $4.00
$50 to 99.99 = $8.00 Shipping $___________
$100 to 199.99 = $10.00
$200 and up = $15.00 Total $___________
(add an additional $5.00 for
international shipments)
Mail
this form along with check or money order (payable to TJDCHF) to:
The Justin Dunn Congenital Heart Foundation
Bryan, TX 77806
