GUIDING REINS
HONOR ROLL SCHOLARSHIP FUND
DONATION FORM
Name
*
Email
*
example@example.com
Phone
*
Donation is made in
Memory of
Recognition of
Military (Active or Veteran)
First Responder
Branch / Community of Service
Information of his/her service (Deployments, Conflicts, Battles, Ships, etc.)
Merits of Distinguish earned /awarded
Is there any additional information about your Honoree you wish to recognize?
What is your relationship to this Honoree?
Do you wish your name to be listed as donor in conjunction with this Honor Roll listing?
Yes
No
DONATION INFORMATION
DONOR NAME(S)
Company
Address
City
State
Zip
Phone
Email
example@example.com
METHOD OF DONATION
Check or money order payable to Guiding Reins.
Please check the box if donating by credit card.
Visa
Mastercard
American Express
Discover
Cardholder Name
Credit Card No
Expiration
CW Code
Date
/
Month
/
Day
Year
Date
Signature
Please accept my donation of $
This is a one-time donation.
This is a recurring monthly donation
Thank you for your generous support of Guiding Reins 501(c)3 which supports our ongoing programs.
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