Yes!
I want to help create outstanding memories for future Central High students! |
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| First Name | __________________________________ | Last Name | ________________________________ | ||
| Address | __________________________________ | Maiden Name | ________________________________ | ||
| __________________________________ | |||||
| City | __________________________________ | ||||
| State | _______ |
Zip Code |
____________ | ||
| Home Phone | ________________ | Daytime Phone | ________________ | ||
| __________________________________ | |||||
| CHS Class of | _______ | ||||
| ____ | Enclosed is my tax-deductible contribution of $25, $50, $100, $500 or other $_________ | ||||
| ____ | My check is enclosed made payable to the Central High School Foundation. | ||||
| ____ | I wish to use my credit card ____ MasterCard ____ Visa ____ American Express ____ Discover | ||||
| Account Number _______________________________________ Expiration Date ___________ | |||||
| Signature ______________________________________________________________________ | |||||
| ____ | My employer will match my gift. I have attached the appropriate form. | ||||
| ____ | I am interested in including the Central High School Foundation in my estate planning. | ||||
| ____ | I would like to make an additional gift to the Scholarship Endowment Fund in the amount of $ _________. | ||||
| If this gift is made in memory or honor of someone, please complete the following: | |||||
| ____ |
In memory of ____________________________ |
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| ____ | In honor of _____________________________ | ||||
|
Please notify: |
_____________________________________________________________ | ||||
| Address: | ____________________________________________________________ | ||||
| City State Zip: | ____________________________________________________________ | ||||
| Notification of your gift will be sent. The amount remains confidential. | |||||
| My Central Memories | ___________________________________________________________________________ | ||||
| ___________________________________________________________________________ | |||||
| ___________________________________________________________________________ | |||||
| ___________________________________________________________________________ | |||||
