GOODWILL REQUEST
On your behalf and that of UGOT, we will send a goodwill gesture to someone who could use a 'pick-me-up'.
My Information:

Name:       Email:        Phone:  

Best time to call me (if necessary):  

Member Needing Goodwill:

Name:       Street Address:  

City:  

Postal Code:      Phone:  

Comments: (please explain, briefly, the reason for your goodwill request)