DONATION INSTRUCTIONS

Please accept my donation in the amount of  $_________.    

Name(s): _______________________________________________

Address: _______________________________________________

City, State and Zip: _______________________________________________

Please make all donations payable to UNICEF and mail to:

Henry D. Miller

4808 Peregrine Point Circle West

Sarasota, FL 34231

941.922.7635

You will receive recognition of your 2011 tax deductible gift directly from UNICEF.