Please print
and use this form for contributions. If making a memorial gift
honoring a friend or family member, a thank you card will be sent
to them in your name.
Once
completed, mail your check and this form to:
BCBA c/o
654D N. Wellwood Ave. # 181
Lindenhurst, New York 11757
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Please accept
my contribution of $___________
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Please
make all
donations payable
to: BCBA
Community Boxing Center Inc. is an ALL VOLUNTEER Non- Profit Corp.
501-C3 doing business as- BCBA | 11-373-1446
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Your Name:
______________________________________________________________________________ |
Address: ________________________________________________________________________________ |
City: ________________________________________
State __________ Zip __________________________ |
E-mail Address:
_________________________________________________________ (To be
held in privacy) |
|_____| My gift is in the name of another
|
In
Memory of: ____________________________________________________________________________ |
In Honor of:
____________________________________________ for the occasion of
___________________ |
_________________________________________________________________________________________ |
Please
Notify :
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Name ____________________________________________________________________________________
|
Address
__________________________________________________________________________________ |
City__________________________________________State____________Zip__________________________ |
|___| |
I've
enclosed a statement of sentiment and support. You have my
permission to place them on your website. |
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...We
thank you for your generosity... |