Salisbury Rotary

GIVE US A HAND
MAKE A DONATION

Please print this page and send with your tax-deductible donation to
Salisbury Rotary Club
PO Box 287
Salisbury, CT 06068

        Name    _________________________________________________________
        Address _________________________________________________________
                       _________________________________________________________
        Phone #  _________________________________________________________  
        E-Mail    _________________________________________________________

      Amount of Donation: $_____________

Do you wish your donation to go toward a specific cause?
check all that apply:

___ Polio Plus      
___ Community Gifts 
 ___ International Needs    
___ College Scholarships  
___ Welcome Home Awards  
___ Back to School for Health  

Thank you   Thank you