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Donation Form Rev3 16 17
Donation Form Rev3 16 17
DONATIONFORM
Yes,IwouldliketoassisttheW ausaukeeSchoolExcellenceinEducationFoundationinensuringqualityeducationin
ourlocals chooldistrict.Iwishtoc ontributetothiseffortinthefollowingway(pleasec heckasapplicable):
MyGiftAmountof$_________________isenclosed.
MyPledgeAmountis$_______________(Pleasec heckonebelow)
Perm onth
Peryear
Startingfrom(date)____________to(date)________________
IaminterestedinbeingontheFoundersPlaque
__$100level(enclosed)
__$500level(enclosed)
__$1,000level(enclosed)
__$5,000level(enclosed)
Nameasontheplaque________________________________________________
MEMORIALdonation.Pleasec hecklevelthatapplies:
Levelsforinclusiononthem ainplaque
__$100level(enclosed)
__$500level(enclosed)
Levelsforindividualplaquerecognition
__$1,000level(enclosed)
__$5,000level(enclosed)
Nameasontheplaque________________________________________________
Asagiftc ardfors omeoneelse.Giftamountof$_____________isenclosed.
Pleaseindicatetheoccasion___________________________________.
AspartofaMemorialfundfors omeonedeceased.Amountof$________________isenclosed.
Pleaseindicatethedeceased____________________________________________.
Ifyouhavedonatedonbehalfofs omeoneandwouldlikeustos endthec ard,pleasefilloutthenameandaddressto
senditto:
______________________________________________
______________________________________________
______________________________________________
Yournameandaddress(requiredtoreceivetaxdeductiblereceipt)
________________________________________________
________________________________________________
________________________________________________
Pleasem akec heckspayableto:W AUSAUKEESCHOOLEXCELLENCEINEDUCATIONFOUNDATION,withM&M
Foundationinthem emoline.
Sendto:WausaukeeSchool ExcellenceinEducationFoundation
P.O.Box258,N11941Hwy141,Wausaukee,WI54177
Thankyoum osts incerelyforyours upport!