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<p ALIGN="CENTER"><font SIZE="5" face="Arial">James Wormley Recognition Project</font></p>
</i></b><p ALIGN="CENTER"><font SIZE="3" face="Arial">Yes! I would like to support the
James Wormley Recognition Project (JWRP) <br>
to memorialize his contributions to public service, education and<br>
entrepreneurship, his high ideals and devotion to humanity and civility.</font></p>
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<p>Name _________________________________________________________</p>
<p>Address _______________________________________________________</p>
<p>City/State/Zip ___________________________________________________</p>
<p>Telephone _______________Fax ______________ E-mail ______________</p>
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<p>Enclosed is my contribution of:</p>
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$25<img border="0" src="images/space.gif" width="15" height="14"></font></td>
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<img border="0" src="images/checkbox-small.gif" width="18" height="17">
$50<img border="0" src="images/space.gif" width="15" height="14"></font></td>
<td width="20%"><font face="Arial" size="3">
<img border="0" src="images/checkbox-small.gif" width="18" height="17">
$100<img border="0" src="images/space.gif" width="15" height="14"></font></td>
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<img border="0" src="images/checkbox-small.gif" width="18" height="17">
$500<img border="0" src="images/space.gif" width="15" height="14"></font></td>
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<img border="0" src="images/checkbox-small.gif" width="18" height="17">
Other _____</font></td>
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<p ALIGN="CENTER">All donations/subscriptions to the James Wormley Recognition
Project (JWRP)<br>
payable to <b><i>The Agribusiness Council, Inc.</i></b><i> (ABC) </i>are
tax-deductible <br>
to the fullest extent allowable by law.</p>
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<p ALIGN="CENTER"><font SIZE="3" face="Arial">The Agribusiness Council is a nonprofit/tax-exempt
educational organization <br>
under IRS Code 501(c)(3). ABC is active in the
formation of recognition <br>
programs aimed at leadership education and
character development.</font></p>
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<p ALIGN="CENTER">Please mail this form with check to:</p>
<p ALIGN="CENTER"><br>
<b>The Agribusiness Council - JWRP<br>
P.O. Box 5565<br>
Washington DC 20016</b></p>
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<p ALIGN="CENTER"><font SIZE="3" face="Arial">Thank You!</font></p>
<p ALIGN="CENTER"><b><font face="Arial" size="2"> </font><i>
<font SIZE="2" face="Arial">"</font></i></b><font FACE="Arial" SIZE="2"><b><i>Building
Bridges with Entrepreneurship, Community Action and Humanitarian Spirit"</i></b></font>
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<p ALIGN="CENTER"><b><i><font size="2" face="Arial"><a href="jameswormley.htm">James
Wormley Recognition Project<br>
</a></font></i></b>
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<p ALIGN="CENTER"><b><i><font size="2" face="Arial"><a href="default.htm">Home</a></font></i></b>
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