Fillable Donation Form Donor Informa4on (please print or type) (Central Community College)

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Donation Form Donor Informa4on (please print or type) (Central Community College)

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The Donation Form Donor Informa4on (please print or type) (Central Community College) form is 1 page long and contains:

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Country of origin: US
File type: PDF

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Donation Form
!
!
Mission Statement: The Founda4on advances
opportuni4es for quality educa4on services in
Nebraska-based ins4tu4ons.
Vision Statement: Improving quality of life;
fulfilling one dream at a 4me.
Donor Informa4on (please print or type)
Name
!
Mailing Address
!
City, ST Zip Code
!
Phone #1 | Phone #2
!
Email Address
!
Dona4on Informa4on
I!(we)!donate!a!total!of!$____________________!to!be!paid:!☐check!☐online.!
Gift!will!be!matched!by!(com pany/family/foundation)!! !
☐form!enclosed☐form!will!be!forwarded!
Please!use!my/our!donation!to!support:!
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________!
Acknowledgement Informa4on
Please!use!the!following!name(s)!in!all!acknowledgements:!! !
! !
☐I!(we)!wish!to!have!our!gift!remain !anonymous.!
!
!
!
Signature(s)
Date
Please!make!checks,! corporate!matches,!or!other!gifts!payable!to:!
!
CENTRAL(COMMU NITY(COLLEGE(FOUNDATION(
201(Foundation(Pl(Ste(200(
Has%ngs, NE 68901-4014
!
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Donation Form Donor Informa4on (please print or type) (Central Community College)

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Completed 26 July 2020

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