GSBF
Donation Form
Annual Campaign Donation Form
Name (Print):_________________________________________
Phone:______________________________________________
Email (Print): ________________________________________
Primary Club Affiliation________________________________
Address (Print): ______________________________________
Amount of Donation: $_________
Please sign if you are using a credit card: ________________________
Payment by VISA or Master Card, Card No. __________________________
Expiration Date:____________
(If you choose to make payment by credit card, your name above
must match name on credit card)
Please designate my donation to the following
account(s): (Percentages may be used to split your donation)
• Golden State Bonsai Federation General Fun
_______
• Golden State Bonsai Federation Collection –North
_______
• GSBF Collection at the Huntington _______
• Other Alternate GSBF Fund _______
(Designated name of Fund:____________________________)
Total
_100%
Make your check payable to GSBF unless making
a payment by credit card. Your donation is tax deductible –
GSBF, Inc. is a non-profit 501 (c)(3) organization. A receipt
will be sent.
Mail payment with this form to:
Lauri Feetham
3284 Charmes Ct.,
San Jose, CA
95135-1100.
We appreciate the use of your stationary and
postage.
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