|
Allen C. Lannom
Endowment Trust Donation |
| _____________________________________________________ |
| Name |
|
|
|
| ___________________ |
_________________ |
___ |
_______ |
| Address |
City |
State |
Zip |
| |
| Donation Amount
Enclosed*: $_______________________________________ |
|
|
|
___ Platinum Baton |
$20,000 plus |
___
Sponsor |
$1000-$2499 |
| ___ Golden Baton |
$10,000-$19,999 |
___ Friend |
$500-$999 |
| ___ Silver Baton |
$5000-$9999 |
___ Contributor |
$1-$499 |
| ___ Fellow |
$2500-$4999 |
|
|
| |
| *All
donations are tax deductible. |
| Please make
checks payable to the Allen C. Lannom Endowment Trust. |
| Send checks and
form to
Faith Lueth, 8 Irving Drive, Walpole, MA 02081 |
|