
DONATION FORM
Enclosed please find my gift in the amount of $
_________________.
Mr./Mrs./Ms./Dr. (please circle)
First Name: ___________________ Last Name:
________________________
Address:
________________________________________________________
City:
Phone: (_____)__________________
Method of payment: ź Check payable
to “Special Olympics San Diego County ”
ź __Visa ź __MasterCard ź __American Express
Card # ____________________________________ Exp. Date
_____________
Signature
________________________________________________________
Your gift is tax deductible to the extent provided by law.
Our Federal Tax Identification number is 95-4538450.
Please print this form and mail it with your contribution
to:
Thank you
for your support!
Register your VONS
CLUB card and support Special Olympics every time you swipe. #_______________