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Otterbein Home Benevolent Fund Lebanon Ohio

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Otterbein Home Benevolent Fund  Lebanon Ohio Powered By Docstoc
					 2010 Good Neighbor Program Sign-Up Sheet
 Please Print

 Name ______________________________________________________
 Phone ______________________________________________________
 Club DLM Number 41890 ___ ___ ___ ___ ___ ___
 Form not valid without Club DLM Number
 Please choose one charity from the list below to which you would like your purchases credited.
 Visit www.dorothylane.com/goodneighbor to register or turn this form in at any
 Dorothy Lane Market location.
 UPDATED 10/29/2010


	741 4 Paws for Ability                        	114   Centerville Women’s Civic Club              	449   Demmitt Elementary Art Program
	429 A Special Wish Foundation, Inc.           	276   Central Presbyterian Church                 	660   Dennis Elementary
      Dayton Chapter                            	436   Chabad Center of Greater Dayton             	132   Dr. John Hole School PTO
	733 Action Youth Outreach                     	116   Chaminade – Julienne High School            	133   Driscoll Elementary School
	542 Agape for Youth                           	484   CHEERS (Communities Helping Each and        	716   East End Community Services
	361 AIDS Resource Center Ohio                         Everyone Reach Success)                     	631   Eastway Behavioral Healthcare
	101 AIM for the Handicapped                   	727   Children’s Hunger Alliance                  	134   E.D. Smith School
	553 Alexandria Montessori School              	107   Children’s Medical Center, Twig 46          	372   Elizabeth’s New Life Center
	283 Alpha Gamma Delta Dayton                  	117   Christ Child Society of Dayton              	136   Emmanuel Altar Rosary Society
      Alumnae Club                              	118   Christ Episcopal Church The Outreach        	383   Emmanuel Evangelical Lutheran Church
	708 The ALS Association Central & Southern            Commission                                  	627   Epilepsy Foundation of Western Ohio
      Ohio Chapter                              	119   Christ Methodist Preschool                  	374   Epiphany Lutheran Church Pantry
	103 Alter High School                         	611   Christ the King Lutheran Preschool and      	528   Epiphany Lutheran Preschool
	373 Altrusa Club of Dayton                            Mother’s Morning Out                        	749   Equestrian Arts Foundation
	104 Alzheimer’s Association,                  	120   Christ United Methodist Women               	705   Fairbrook Elementary
      Miami Valley Chapter                      	693   Circle Tail, Inc                            	137   Fairhaven Church
	435 American Cancer Society                   	419   CITYFOLK                                    	300   Fairmont High School
	689 American Institute of Wine and Food-      	482   Clearcreek Elementary School                	727   Fairmont High School Athletic Boosters
      Dayton Chapter                            	399   Cline Elementary                            	228   Family Network
	670 American Red Cross-Dayton Area Chapter    	630   Clothes That Work!                          	403   First Church of Christ Scientist–Centerville
	730 Antioch College Annual Fund               	487   Coffman Family YMCA                         	139   First Church of Christ Scientist–Dayton
	516 Apex Community Church                     	532   Concordia Lutheran Church Preschool         	220   First Lutheran Church
	530 Artemis Center for Alternatives to        	488   Covenant Prebyterian Church                         (Backdoor Ministry Fund)
      Domestic Violence                         	390   Cox Arboretum                               	500   Fisher/Nightingale Houses, Inc.
	234 Arthritis Foundation                      	467   Cub Scout Pack 151                          	632   Five Oaks Neighborhood Improvement
	704 Ascension Church                          	615   Culture Works                                       Association
	510 Asian Arts Center                         	525   Cystic Fibrosis Foundation Great Strides—   	659   Five Points Elementary School-East
	265 Aullwood Audubon Center                           Dayton Office                               	661   Five Points Elementary School-West
	683 Autism Society of America – Dayton        	123   Daniel Cooper Chapter DAR                   	451   For the Love of Children (FLOC)
      Chapter                                   	637   DARaluz Network Inc.                        	690   The Foundation for Community Blood
	369 Aviation Trail, Inc.                      	124   David’s United Church of Christ                     Center/Community Tissue Services
	671 Beaver Creek Wetlands Association         	261   Daybreak                                    	140   Four Seasons Garden Club
	695 Beavercreek Church of the Brethren        	592   Dayton 32° Masonic Children’s               	507   Franklin Food Pantry
	602 Bellbrook Community Church                        Learning Center                                     (Franklin Area Community Services)
	571 Bellbrook Garden Club                     	621   Dayton Area Families for Effective          	591   Franklin Montessori School
	405 Ben Columbus Scholarship for Fairmont             Autism Treatment (DAFEAT)                   	561   Franklin-Springboro Public Library
      Grad at UD                                	726   Dayton Area Rabbit Network                  	442   Friends of Benham’s Grove
	365 Beth Abraham Synagogue                    	236   Dayton Art Institute                        	462   Gamma Phi Beta Dayton Alumnae
	657 Bethlehem Temple First Apostolic Church   	666   Dayton Boat Club                            	141   Garden Club of Dayton
	456 Beth Jacob Congregation                   	711   Dayton Ballet                               	588   GDAA Rent Foundation
	108 Bishop Leibold School                     	128   Dayton Chapter of Hadassah                  	515   Gem City Ballet
	714 Blue Star Mothers - Miami Valley          	728   Dayton Christian Fine Arts Boosters         	367   Girl Scouts of Buckeye Trails Council
      Chapter #3                                	699   Dayton Christian Middle School              	651   Glen Helen Association
	655 Boys & Girls Club of Dayton, Inc.         	129   Dayton Christian School – Elementary        	734   Golden Retriever Rescue – GRRAND
	600 Boy Scouts of America – Troop 50          	513   Dayton Contemporary Dance Company           	142   Good Neighbor House
	375 Boy Scouts of America – Troop 236         	268   Dayton Cycling Club                         	193   Good Samaritan Hospital
	109 Boy Scouts of America – Troop 320         	722   Dayton Gay Men’s Chorus                     	143   Grace United Methodist Women
	243 Boy Scouts of America – Troop 516         	237   Dayton History                              	144   Grace Women’s Missionary Council
	715 Boy Scouts of America – Troop 767         	634   Dayton Jewish Community Center              	412   Graceworks Lutheran Services
	425 Breast Cancer Foundation                          Early Childhood Services                    	568   Grandview Foundation
	713 Bridge Riding for the Disabled            	748   Dayton Literary Peace Prize                 	679   Greyhound Adoption of Greater
	649 Bright Beginnings Christian Preschool     	723   Dayton Mercy Society                                Cincinnati
	448 Building Bridges Inc.                     	656   Dayton Ministries in Higher Education       	687   Greater Dayton Rowing Association
	417 Camp Emanuel                              	736   Dayton Music Club                           	438   Greater Dayton Volunteer
	626 Carousel House School                     	358   Dayton, Ohio Habitat for Humanity                   Lawyers Project, Inc.
	229 The Castle                                	677   Dayton Opera Association                    	643   The Greater Dayton Mediation Center
	368 Celebration of Life Church                	640   Dayton Peace Museum (Dayton                         (Mediation Services Fund)
	732 Centerville Band Boosters, Inc                    International Peace Museum)                 	145   Greek Orthodox Church Senior Citizens
	539 Centerville Community Church              	493   Dayton Philharmonic Orchestra Assoc.        	729   Greene County Community Foundation
	110 Centerville Education Foundation          	224   Dayton Public Radio FM 88.1 and 89.9        	709   Greene Leaf Therapeutic Community
	111 Centerville High School                   	719   Dayton Raiders Swim Club, Inc.              	146   Hadley E. Watts Middle School PTO
	257 Centerville Historical Society            	130   Dayton Right to Life, Inc.                  	496   Hannah’s Treasure Chest
	112 Centerville Primary Village North PTO     	411   The Dayton Theatre Guild                    	147   Harman PTO
	672 Centerville Primary Village South PTO     	508   Dayton Vineyard Church                      	738   Helping Hands of Dayton
	490 Centerville Preschool                     	400   Dayton Visual Arts Center                   	150   Hillel Academy
	612 Centerville Science Olympiad              	546   Dayton Woman’s Club                         	194   Hithergreen Senior Center
	113 Centerville United Methodist Women        	227   DCDC First Baptist Church of Dayton         	151   Holy Angels School
	712   Holy Trinity Church                            	172   Oakwood Historical Society                   	200   St. Albert the Great Church
	418   Homefull (formerly known as The Other Place)   	274   Oakwood Jr./Sr. High PTO                     	521   St. Andrew’s Episcopal Church
	706   Hope Lutheran Church                           	175   Oakwood United Methodist Mission             	413   St. Anthony Catholic Church
	286   Hospice of Dayton, Inc.                        	522   The Ombudsman’s Office                       	201   St. Charles Art Department
	432   House of Bread                                 	233   Opera Guild of Dayton                        	720   St. Francis de Sales Catholic Church
	652   House of the People                            	178   Orchard Park School                          	376   St. Francis of Assisi Church
	277   The Huesman Heart Foundation                   	370   Oregon Historic District Society             	472   St. Francis Episcopal Church
	406   Human Race Theater                             	620   Otterbein Lebanon Retirement                 	202   St. George’s Episcopal Church
	222   Humane Society of Greater Dayton                       Community Benevolent Care Fund               	491   St. James United Methodist Church
	710   Humane Society of Greene County                	179   Otterbein U.M. Church                        	203   St. John’s United Church of Christ
	214   Incarnation School                             	520   Outreach for Animals                         	718   St. John the Baptist Catholic Church
	678   Information Radio                              	725   Ovarian Cancer Alliance of Southwest         	454   St. Joseph Church
	564   Interfaith Hospitality Network for                     Ohio                                         	266   St. Leonard Faith Community
        Homeless of Greene County, Inc.                	594   Parents in Motion (Springboro Minds          	270   St. Leonard Foundation
	556   Jewish Senior Service Agency                           in Motion Learning School)                   	439   St. Luke Catholic School, Beavercreek OH
	154   John F Kennedy Elementary PTA                  	698   Parkview United Methodist Church             	226   St. Mark’s Episcopal Church
	155   Jonathan Dayton Chapter DAR                    	739   Partners For Community Living                	559   St. Mary’s Conference of St. Vincent
	471   The Jonathan Wright Chapter, DAR               	180   PEO Chapter AN                                       de Paul
	389   Junior League of Dayton                        	182   PEO Chapter CI                               	106   St. Paul’s Episcopal for The Food Bank
	156   Juvenile Diabetes Foundation –                 	183   PEO Chapter DS                               	378   St. Vincent Hotel
        Dayton Chapter                                 	184   PEO Chapter Z                                	464   Stingley Elementary School
	404   K12 Gallery for Young People                   	185   PEO Sisterhood Chapter CK                    	453   Sugarcreek Local School District
	225   Kettering Children’s Choir                     	187   PEO Sisterhood Chapter CN                    	273   Suicide Prevention
	596   Kettering Noon Optimist Club                   	186   PEO Sisterhood Chapter CV                    	534   Sycamore Glen Retirement Community
	685   Kettering Parks Foundation                     	747   Pet Advocate League                          664    Tecumseh Land Trust
	255   La Leche League of Beavercreek                 	398   PFLAG Parents, Families and Friends of       	215   Temple Beth Or
	503   La Leche League of Centerville                         Lesbians and Gays                            	575   Temple Beth Sholom—Middletown, OH
	159   League of Women Voters –                       	188   Pi Beta Phi Alumnae Club                     	246   Temple Israel
        Greater Dayton Area                            	189   Planned Parenthood Southwest Ohio            	735   The Foodbank, Inc.
	480   Learning Tree Farm                                     Region                                       	396   The Tenth Life
	737   Life Enrichment Center                         	478   Premier Community Health                     	407   Therapeutic Riding Institute
	457   Linda Williams Ministries/Kids Rock            	531   Progressive Animal Welfare Society           	523   Think TV
	160   Lutheran School of Miami Valley                        (PAWS)                                       	552   Tower Heights Middle School
	691   LUV 4 K9’s                                     	609   Project READ                                 	665   Tree of Life, Inc.
	463   Magsig Middle School PTO                       	731   Radio Maria, Inc.                            	702   Trinity Community of Beavercreek
	743   March of Dimes                                 	654   Reach Out of Montgomery County               	431   UD Bombeck Family Learning Center
	721   Miami Monthly Meeting Religious                	745   Rebuilding Together Dayton                   	724   Unified Health Solutions
        Society of Friends                             	253   Reformation Lutheran Church                  	717   Van Buren Middle School PTO
	489   Miami Valley Child Development                 	673   Rhythm in Shoes                              	676   Victoria Theatre Association
        Centers, Inc                                   	697   Roads to Recovery                            	586   Warren Co. Humane Association
	240   Miami Valley Down Syndrome                     	696   Robyn’s Nest Rescue                          	593   Warren County Abuse & Rape Crisis Shelter
        Association                                    	192   Ronald McDonald House of Dayton              	669   Warren County Community Services, Inc
	219   Miami Valley Literacy Council                  	558   Rotary Club of Springboro                            (WCCS)
	581   Miami Valley Pet Therapy Association           	744   Saddle Up For The Cure                       	548   Washington-Centerville Public Library
	162   Miami Valley School                            	650   Samaritan Homeless Clinic                    	613   We Care Arts
	703   Miami Valley Symphony Orchestra                	579   Second Church of Christ, Scientist, Dayton   	209   WELCA of the Lutheran Church of
	163   Miami Valley Unitarian Fellowship              	599   Secret Smiles of Dayton, Inc.                        Our Savior
	164   Miami Valley Women’s Center                    	465   The Seedling Foundation for                  	402   Weller PTO
	647   Miamisburg Band Boosters                               Stivers School For The Arts                  	502   Widows Home Foundation
	420   Miamisburg Christian Academy                   	694   SHA Youth Hockey                             	212   Womanline
	469   Miamisburg Historical Society –                	244   Shriner’s Hospitals for Children             	210   Women of Fairmont –
        Research & Resource Room                       	197   SICSA                                                Fairmont Presbyterian
	560   Missions Possible Inc.                         	740   Sigma Beta - Epsilon Omicron                 	211   Women of Westminster –
	166   Montessori Center of South Dayton              	551   Small Paws Rescue, Inc                               Westminster Presbyterian Church
	356   Montessori School of Centerville               	377   South Dayton Dance Theatre                   	380   WORDS Radio Reading Service
	381   Montgomery County Juvenile Court               	199   South Park United Methodist Church           	547   Wright Memorial Public Library
        CASA Program                                   	486   Southbrook Christian Church                  	371   WYSO Public Radio
	692   Montgomery County Learning Center-             	216   Southdale School PTA                         	707   Xenia Christian School
        West                                           	278   Southern Hills United Methodist Church       	360   YoungLife
	223   Muse Machine                                   	239   Southminster Church PW                       	259   YWCA of Dayton
	254   National Multiple Sclerosis Society            	590   Southwest Church                             	249   Zeta Tau Alpha Dayton Alumnae
        (Western Ohio Chapter)                         	501   Southwestern Ohio Search and Rescue          	517   Zion Memorial UCC Church
	746   Noble Circle Project                           	416   Springboro Band Boosters
	167   Normandy Elementary School                     	607   Springboro Intermediate
	168   Normandy United Methodist Church               	543   Springboro Jr High National Junior
	169   Oak Creek United Church of Christ                      Honor Society
        Women’s Guild                                  	541   Springboro Optimist Club
	440   Oak Tree Corner, Inc.                          	742   Springboro United Church of Christ
	494   Oakwood BSA Troop 101                          	658   Spring Valley Academy
	427   Oakwood High School                            	524   St. Agnes Corpus Christi Outreach Ministry


 I understand that a percentage of my purchases (from this date forward) made with my
 Club DLM card will be rebated to the charity of my choice once I have spent $500.00 dur-
 ing 2010. This program will be in effect from January 1, 2010 through December 31, 2010.

 Signature _______________________________________________________

 Date ___________________________________________________________

				
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