Donations by Check for the GIVE BACKpacks Campaign
Please complete this form, print a copy and include it on your envelope with your check.
Salutation *
Your Name as it appears on the Check *
Your answer
Additional Name on the Check
Your answer
Name of PTA, Company or Organization
Your answer
Street Address - (No abbreviations for street suffix - i.e., Street, Boulevard, Avenue, etc.) *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Phone Number
Your answer
Donation Amount *
Your answer
Check Number *
Your answer
Date of Check *
MM
/
DD
/
YYYY
Is this an anonymous donation? *
How did you hear about our campaign?
Thank You!
Please print a copy for your records. You may send your check or money order made payable to the MCPS
Educational Foundation with any acknowledgement information to:

MCPS Educational Foundation, Inc.
P O Box 1007
Rockville, MD 20849 - 1007

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