Humane Fire Company No. 1

        ♦ Proudly Serving Royersford Borough and Portions of Upper Providence Township ♦

              We are a not-for-profit organization.  Your donation is tax deductible.

Name       _________________________          Donation Amount (please circle):    

Address    _________________________          $50      $25     $15      Other $____

                 _________________________                    

City          _________________________                

State         _______            Zip _________

□  I would be interested in volunteering.  Please contact me at _________________

        Please mail this completed form to:            Humane Fire Company

                                                                             301 Walnut St.

                                                                             Royersford, PA  19468