Name: __________________________________________________________
Unit _______________________________________
Address: _______________________________ City: ______________
State: ____________ Zip Code: ___________ Phone: __________
The above named Scouter or Unit wishes to “purchase” ____ lot(s)
as part of a once in a lifetime offering to support
the Cub Scout Family Camp.
Enclosed is $_______ ($100.00 per lot)
---or---
Please bill me for $______ ($100.00 per lot) as follows:
Once Immediately ___
Other _________________
---or---
Charge my Visa/MasterCard (circle one)
Card Number _____________________________ Exp. Date ______
Please clearly print below how you want the “Deed” to read:
_________________________________________
Thank You