Enclosed is my tax-deductible donation of:

$50______ $100 _____ $500 _____ Other $_________

My check is made out to the Foundation for Cardiac Research to aid in its research and fight against heart disease, America's number 1 killer. No officer or member of the board of directors takes any fee for such service to the Foundation.

Name: ______________________________________________________________

City: ____________________________________ State_____ Zip___________

Acknowledgment (Fill Out If You Want an Acknowledgment Sent To Someone) .

In honor of: _______________________________________________________

In memory of: ______________________________________________________

In celebration of: _________________________________________________

Send To: ___________________________________________________________

Address: ___________________________________________________________

Your Name on the Acknowledgment: ___________________________________