Name:_______________________________________________________________

Address:_____________________________________________________________

City;____________________________State:___________Zip:_________________

Telephone:_____________________________Cell___________________________

My / Our gift of

___$100          ___ $250          ___$500          ___$1000          Other_______is enclosed.

This gift is:  IN MEMORY OF___________________________________________

and / or

IN HONOR OF________________________________________________________

Yes, I would like more information on Naming Opportunities.  Please contact me. _______

Please make gifts payable to: Rock River Center, Inc.

215 W. Washington St.

Oregon, Illinois 61061

815-732-3252

1-800-541-5479

815-732-4318   Fax

www.rockrivercenter.com

Rock River Center, Inc. is a 501(c) (3) non-profit organization.