Donor Form

The Asnuntuck Community College Foundation welcomes contributions in many forms:

• Mail cash contributions to ACCF, 170 Elm Street, Enfield, CT  06082.

• Donor Form (Word doc)
• Donor Form (PDF)

DONOR FORM:

Yes, I want to help support quality education at Asnuntuck Community College. 

My donation is:

__ $10              __ $35              __ $50              __ $100           __ $500         

__ $1,000            __ other amount:  $________

__  My check payable to ACC Foundation is enclosed.

__  Please bill my credit card ($35 min.)    __ M/C   __ VISA   __ Discover

Card number _____________________________________

Exp. Date ________________ Security Code ___________

Signature ________________________________________

Billing address ____________________________________

________________________________________________

Donors of $35 or more become members and are invited to special events.  First-time

members receive the following membership premiums:

$50  car magnet     $100  keychain     $250  coffee mug     $1,000  afghan  

$500     wall clock

__  Thank you.  I prefer that my donation benefit the students directly and fully. 

Please do not send me the premium.

Donor name ________________________________________________________

(as it is to appear on the Donor List)

Mail address ________________________________________________________

__________________________________________________________________

Email _______________________________ /____ Yes, you may send me College email

__ My company matches my gifts.  Completed form enclosed. 

Company name _____________________________________________________

Return to:

Asnuntuck Community College Foundation, 170 Elm Street, Enfield, CT  06082

860-253-3041

THANK YOU

ACCF is a 501 (c)(3) nonprofit organization. 

All gifts to the ACC Foundation are tax deductible to the extent of the law.