Sample Donation Form
Please go to the Squadron website to get the actual form.



Name:            _______________________________________________________________________
Address:        _______________________________________________________________________
City, State, Zip:    _______________________________________________________________________
Email Adress:        _____________________________________________
Home Phone:        ________________        Cell/Alt Phone:    _______________

I pledge to make a donation to the 3rd Squadron 5th Cavalry Memorial Relocation fund as indicated below. 
Signature: _____________________________________________________________________
Cash Donation  (place a checkmark for the year(s) and amount that you are pledging for)
        _____ Yearly Donation for the year(s): __ 2015,  __2016, __ 2017 in the amount of;
            ___  $500     ¬¬¬___ $1000    ___ $1500    ___ $2000
         _____ Monthly Donation for the year(s): __ 2015, __ 2016, __2017 in the amount of;
            ___ $25   ___ $50    ___ $___
        _____ One time cash donation of $________

  Please print clearly and double-check your spelling.

 

Maximum of 3 lines, 20 characters per line. Blank spaces count as a character

 

For additional pavers please complete and attach a form for each one and send with one payment.

 

___   Custom 4”x8” Engraved Granite Paver for a donation of $100

___   Duplicate 2”x4” paver(s) for $25 each

___   4”x8” Engraved Granite Paver in memory of our KIA for $100. Please indicate for which troop  you would like your donation applied to:

  __HHT   __ A Trp  __ B Trp   __ C Trp   __ D Trp .

All efforts will be made to have your paver engraved with the name of a brother in the troop you indicate.

Another troop may be substituted in the case where enough pavers for a given troop have been donated

                                                                                                                                                               

Total Amount for pavers  $____________

Make checks payable to “Black Knights” and mail form and payment to:

                Richard J. Wandoff

                119 Victorian Lane

                Jupiter, FL 22458

Fill in below what you would like

                                                                                                                                                               

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