DONATION FORM

DONATE ONLINE NOW OR PRINT THIS FORM AND MAIL WITH YOUR DONATION TO ONE OF THE ADDRESSES LISTED BELOW:


COLLINS FAMILY SCHOLARSHIP FUND
c/o FRANCES COLLINS
708 READ AVENUE
CINNAMINSON, NJ 08077

OR:
COLLINS FAMILY SCHOLARSHIP FUND
c/o BRENDA COLLINS
PO BOX 53623
PHILADELPHIA, PA 19105-3623

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NAME

ADDRESS

CITY                               STATE/PROVINCE

ZIP                         COUNTRY

PHONE                                 FAX

EMAIL ADDRESS (not required)

AMOUNT OF DONATION $                 CHECK         MONEY ORDER

(Foreign donations should be drawn on a U.S. bank and made payable in U.S. funds)


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MAKE YOUR CHECK PAYABLE TO:

Collins Family Scholarship Fund

For additional questions, please contact us by email.

Thank you for your donation. We truly appreciate your contribution. All donations are tax deductible to the full extend allowed by law. All donations will be acknowledged.