Wisconsin Right to Life
January 22nd 2016 Commemoration Ad Order Form Compliments of the Wisconsin Right to Life Education Fund, the January 22nd commemoration ad is FREE of CHARGE to Chapters of Wisconsin Right to Life. If you have questions, please contact Mike Froncek, (414) 778-5780, extension 212 or send email to
[email protected] and you will receive a prompt reply. Once your fully completed order form is received, an electronic version of the ad (customized with your chapter’s mailing address) will be sent as a PDF via email to you AND your newspaper contact.
PLEASE COMPLETE ALL FIELDS OF THIS ORDER FORM and mail it no later than January 5, 2016 to: Wisconsin Right to Life, Attn: Mike Froncek, 9730 W. Bluemound Rd. Suite 200, Milwaukee, WI 53226
Name of Chapter as it should appear in the ad: I want the following address to appear in the ad so readers will know where to mail their donations to our chapter: Address: City, State, Zip: Chapter Leader’s Name, Phone and Email:
Newspaper contact person’s Name, Phone and Email:
