Adding number 10261 to your Randall's Good Neighbor Card Form

Texans you can help Discover Technology raise funds by adding 10261 to your Randall's Good Neighbor card or complete the following form we will register it with Randall's. By doing this Randall's will give 1% of the money that they receive to Discover Technology. There is no cost to you. The money comes from the money that Randall's receives.   This money will be used to buy needed adaptive equipment (which is usually very expensive) for persons with disabilities.

We will not do anything with the information that you provided but add the information to your card and send you a thank you message.  If you have any questions you can contact Amantha at dtinc8888@hotmail.com. Thank you. Amantha Cole, Founder of Discover Technology, Inc. 

To Learn more about Discover Technology, Inc. please go to your web site at http://discovertechnology.com.

Please provide the following information:

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail

Remarkable Card Number

Amantha Cole
Copyright © 2003 [Discover Technology, Inc.]. All rights reserved.
Revised: 01/22/05