Hill 4-11 Association

Donations Form

(Please print and then complete form)

Anyone wishing to make a donation* to the Hill 4-11 Association, please use this form and mail it as instructed below:

Name and Address:

Name:_______________________________________

Street:_______________________________________

City:_______________________  State:________  Zip:____________

Phone:___________________  E-mail Address:___________________

Date:__________________  Signature:_______________________________________



Please indicate how your donation should be applied:

Leslie J. Stottle Memorial Scholarship Fund: $  ______
General Fund: $  ______
Web Site Support Fund: $  ______
Total: $  ______
* Donations to the Hill 4-11 Association are not tax deductible.

Please make check payable to Hill 4-11 Association and mail it along with this form to:

Hill 4-11 Association
ATTN: Dick Hill, Treasurer
630 Woodside Dr.
Kent, OH 44240-2664