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Donation Form - Jim Marken

This donation form collects donor information such as name, address, phone number and email. It asks for a donation amount to be given to the Alzheimer's Association and allows the donor to pay by check or credit card. It also collects optional information about who the donation is being made on behalf of at a specific Walk to End Alzheimer's event.

Uploaded by

Laura Lucas
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
101 views1 page

Donation Form - Jim Marken

This donation form collects donor information such as name, address, phone number and email. It asks for a donation amount to be given to the Alzheimer's Association and allows the donor to pay by check or credit card. It also collects optional information about who the donation is being made on behalf of at a specific Walk to End Alzheimer's event.

Uploaded by

Laura Lucas
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Donation Form

Donor Information
First Name: _____________________________ Last Name: ____________________________________
Billing Address: ________________________________________________________________________
City: ____________________________________________ State: ______________ Zip: _____________
Phone number: _________________________ Email Address*: _________________________________

*Email address will be used only to send donation receipt.

Donation Information
I would like to make a donation in the amount of:
__$1000 __$500 __$250 __$120 __$60 __$35 __Other Amount: $___________

Payment Method
___ Enclosed is my check payable to the Alzheimers Association
-ORPlease charge my: ____Visa ____MasterCard ____American Express
Credit card number: _____________________________________________________________________
Expiration date: ___________________
Signature: ____________________________________________________________________________
Todays date: _____________________

Participant Information (donation on behalf of)


Event Name: San Jose Walk to End Alzheimers
Participants Name: Jim and Linda Marken
Participants ID: 6575718
Team Name: Hazels Happy Memories
Company Name: Staff Team Plaques
Mail this form and contribution to:
San Jose Walk to End Alzheimers
31915 Rancho California Road #200-438
Temecula, CA 92591

Thank you for your contribution!

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