Lawson State Community College Foundation

Contribution Response Form

Please let us know the following so that we may properly credit your contribution:

Mr./Ms./Mrs./Dr. (       ) _______________________________________________________________________

Address _______________________________________________   Phone (        ) ________________________

City ______________________________________________   State _________________    ZIP ____________

E-mail Address ______________________________________________________________________________

Did you attend Lawson State?  _____ Yes  _____ No   When __________________________________________

I am please to make the following contribution as a part of the Campus Giving Program.

  _____ $100     _____ $250     _____ $500     _____ $1000     _____ $2,500     _____ $5,000     _____ $10,000

Other_______________ ______________________  Specify your preferred amount, if different from those above.

Indicate Type of Transaction:

 ____ Personal Check  ____ Cashier's Check  ____ Money Order  ____Cash  ____ Credit Card  ____Payroll Deduction   

_____ I would like to fund a scholarship

I would like to contribute by:  ____ Check  ____ Stocks & Bonds  ____ Real Estate & Property  ____ Planned Gifts   

Apply my contribution to:  ____ Visa  ____ Mastercard  ____ Discover  ____ American Express   

Card # ______________________________________________________________________________

Name Printed on Card ____________________________________ Signature _____________________________

Please make checks payable to:  Lawson State Foundation