Welcome to Ronald McDonald House Charities of the Central Valley, inc.

-------------------------Complete the form and mail or fax to:

Ronald McDonald House Charities
of the Central Valley, Inc.
9161 Randall Way
Madera, CA 93638
Phone: (559) 447-6770 Fax: (559) 447-6778

Questions, please contact Patty Manfredi
at (559) 261-3662 or
patty@ronald-mcdonaldhouse.com

Registration Form

Sponsor :_____________________________________________________

Contact Person:______________________________________________________

PHONE:______________________________________________________

ADDRESS:____________________________________________________

CITY:________________________________ STATE:_________________

ZIP:___________________

Phone:________________________ Fax: __________________________

EMAIL:________________________________________________________

Level of sponsorship: --------------------------------------------

Premiere ($20,000)
Gold Legacy ($10,000)
Compassion ($5,000)
Red Heart ($2,000)
Prestigious ($1,000)
Caring ($75)
Other

Signature_______________________________________ Date___________

Comments:

----------------------------------------------------------------------

RMHC Use Only
________________________________________________________________

Check Received ______________ Amount ________________ By _________

Goods Received ______________ Amount ________________ By _________

_________________________________________________________________