2012-13 Donation Form

                YES, I would like to support our children’s education by making a gift to the

                Sierra Madre School Annual Fund!!!

Enclosed is my gift in the amount of:

$1,000 ______   $500______   $250 ______ $100 ______ Other: $ _______  (any amount is appreciated!)     

Name: ________________________________________________________________________________________________  

         (As you would like it to appear on any acknowledgements)

I would like this gift to be anonymous

Children’s Names: ____________________________________        Teacher(s): _____________________________________

Address: ______________________________________________________________________________________________________

Phone Number: _____________________________________   E-mail: _____________________________________________

  My check, payable to Pasadena Educational Foundation (with Sierra Madre School Annual Fund

written on the memo line), is enclosed

  Please charge my gift to  ___ Visa  ___ MasterCard

Acct. #  ________/________/________/_______              Exp. Date ________________

Enter billing address (if different from above): ___________________________________________________________

Authorized Signature _________________________________________

  I am interested in making a monthly pledge in the amount of $_________________.  Please contact me to facilitate this donation.

  My employer participates in a Matching Gift program.  Please contact me to facilitate a

matching fund contribution by my employer

Tax deductible to the fullest extent of the law.

 INSTRUCTIONS

                Fill out this form, attach your donation, and turn it into the school office (at either the Lower Campus or Upper Campus). 
Thank you for your contribution!!!!