Please use my gift as follows:

$_______ General Fund

$________ Web Site Development

$________ International Travel Scholarships

$________ Program Development

Name _________________________________

Phone _________________________

Email _____________________________

Address ________________________________

City _____________________

State _____________

Zip ____________ Country _______________

Please send your contribution to:
Lori Levine
Shamanic Circles (TSC)
2 N Sierra Vista Drive
Tucson, AZ 85719

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Please check our website for information. You will be able to register for the International Gathering in Spring 2002 in Oracle, Arizona.at our website www.shamaniccircles.org

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