KTC Meditation-Thon Donation Form

Please use your Browser to print this form. Return your completed form by mail to:

KTC Minneapolis
4301 Morningside Road
Edina, MN 55416-5031

or FAX your completed form to (952) 926-5049

I would like to sponsor the number of minutes of meditation checked below for $1 per minute:

____30 ____45 ____60 ____90 ____120 ____240 ____Other Total $______

______ Check Enclosed (Please make payable to KTC Minneapolis.)

______ VISA or ______ MasterCard

____ ____ ____ ____ ____ ____ ____ ____ ___ ____ ____ ____ ____ ____ ____ ____
exp. ____/____

Home Phone Number (Please include when using credit card.):

Your Name (Please Print):

___________________________________________________________________________________

Address:

___________________________________________________________________________________

City: ___________________________________ State: ________________ Zip:________________

Email Address:______________________________________________________________________
(To be held in privacy. If you provide your email address we will confirm your donation by email.)