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Founded in 1978
Annual Campaign Donation Form - 2004
Name (Print):_________________________________________ Phone:___________________ Email (Print): ___________________________________ Primary Club Affiliation______________________ Address (Print): _________________________________________________________ Amount of Donation: $_________ Please sign if you are using a credit card: ________________________ Payment by VISA or Master Card, Card No. _________________________________ Expiration Date:____________ (If you choose to make payment by credit card, your name above must match name on credit card) Please designate my donation to the following account(s): (Percentages may be used to split your donation)
(Designated name of Fund:______________________________________) Total ._100% Make your check payable to GSBF unless making a payment by credit car. Your donation is tax deductible GSBF, Inc. is a non-profit 501 (c)(3) organization. A receipt will be sent. Mail payment with this form to: Betty Pitts, 2701 Corabel Lane, #55, Sacramento, CA 95821. We appreciate the use of your stationary and postage. |
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