North Beach Elementary - AGC Family Form

North Beach Academic Giving Campaign (AGC)
2011-2012 AGC Donor Form

Art, Music, Tutoring, Technology In The Classroom

You can help the AGC reach its fundraising goal by pledging or donating today. It costs approximately $175 per student to provide these services.

All donations are tax deductible and a receipt will be provided to you for tax purposes.

Yes, I would like to donate to the North Beach AGC!

Your Name:

Your Email:

Your Address (street, city, state, zip):

Child #1 Name:

Child #1 Grade:

Child #1 Room:

Child #2 Name:

Child #2 Grade:

Child #2 Room:

Child #3 Name:

Child #3 Grade:

Child #3 Room:

We would like to make a one time tax deductible gift of:

$100.00
$175.00
$250.00
$500.00
$750.00

We would like our tax deductible gift of:

Donation Amount:

to be made in installments of:

2 payments (Oct & Feb)
4 payments (Oct, Nov, Feb, Mar)

We would like to pledge in the amount of:

Pledge Amount:

and will send our gift in (Month/Year):

You may also donate online right now:

Download 2011-2012 AGC Donor Form

If you have any questions regarding the AGC please contact:
Tina Kliman, AGC Co-Chair jedkliman@comcast.net
or
Stacey Hackney, AGC Treasurer and Co-Chair staceyhackney@yahoo.com