Untitled Document

Yes, I want to support STRIVE!

Enclosed is my gift of
My company has a matching gift program. Enclosed please find my completed form.
Donors of all levels will be listed in our next monthly newsletter.
Please check here if you want your gift listed as anonymous.

Please print this form, mail it and make your check payable to:
STRIVE
28 Foden Road, South Portland, ME 04106
Your gift is tax deductible to the extent permitted by law.
Please list your name as you wish it to appear in our monthly newsletter.

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Phone
Fax
Email
My Gift is :
In Honor of
In Memory of
Please send notification of this tribute to:
Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Thank you!