To adopt a pipe, print out this form.  Then choose and check a size (which determines the financial level of sponsorship) and voice.  Provide your name and address, and mail this form with your check, payable to Good Shepherd Organ Fund, to the address below.  If your adoption of a pipe is in memory of someone, please provide that information, as well.  Thank you for your support.

Carole Kennedy
Organ Fund
531 Main Street
Roosevelt Island
New York NY 10044
USA

	US$	Flute	Reed	Principal	String
Small	25
Medium	50
Large	100
Octave	500

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