PRINT & MAIL TO:
N.Y. FIREFIGHTERS BURN CENTER FOUNDATION
21 ASCH LOOP, BRONX, N.Y. 10475
Please provide the following ordering information:
Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
DESCRIPTION
BURN WISE (PREVENTION VIDEO)
TOTAL NUMBER OF VIDEOS ORDERED
($15 EACH) ($25-ANY TWO) ($95 - ANY EIGHT) ($160 - COMPLETE SET OF 16)
TOTAL ENCLOSED DONATION (ADD $3.00 PER ORDER FOR POSTAGE AND HANDLING)