Dayton Foundation Logo THE CARL B. KERN FUND

On-Line Request for Additional Information Form
last updated May 24, 1998

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Instructions: Please fill in the boxes below and then click on the literature that you would like to receive concerning The Carl B. Kern Fund or The Dayton Foundation. Note that the boxes marked with a double-asterisk (**) MUST be entered so that this form can be processed successfully. Thanks.

Hint: Move your cursor to the inside of each box, click, then start typing. When you're done typing inside the box and want to move to the next box, press the TAB key or move your cursor to the next box and click. DON'T press the ENTER key, because that is the same as clicking on the "Send Request" button at the bottom, and it may send off this form for processing before you're done completing it. Multi-color Bar

Name --------------- **

Address Line #1 ---- **

Address Line #2 ----

City & State --- **, ** .. Zip (+4 if known) --- ** -

Area Code, Phone Number -- () - -

E-mail Address --- **

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Information to be Sent

Please click on the checkbox(es) for the information being requested:

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Comments? Questions?

Please type in your feedback below:

Multi-color Bar This will send an e-mail message to the current Advisory Board Chair with your request(s).
This will clear all the above info entered so you can start over.

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