Donation Form

Dear donor: This online form compliments your mail donation with important information. Alternatively, click here if you prefer to download, print, and fill out this form to add it to your mail donation.

PLEASE MAKE CHECK OR MONEY ORDER PAYABLE TO Central Pennsylvania Community Foundation:

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone*

Email*

Donation Amount*

Name of Fund*

If other than yours, under what name do you wish your donation to be noted?

If your donation is in honor (living) of someone, please provide the name and mailing address for the person so that we can send them a card acknowledging the gift in their honor.

If your donation is in memory (deceased) of someone, please provide the name and mailing address for the person that you would like us to send a memorial card.

Do you have any additional instructions?

THANK YOU!
1330 11th Avenue, Altoona, PA 16601 | (814) 944-6102 | www.centralpagives.org