Special Senior Class Gift Donation Form
Support Your High School
The students from UA3 Club have created a Donor Plaque which is hanging in the lobby to honor BCCHS students and teachers. Please consider making a tax-deductible donation to have your child’s name included on the donor board. Proceeds will be used to provide arts enrichment and other supports for BCCHS.

Donation Levels:
• Baruchian Patron $750 or more
Include your seniors name on a gold tag on the donor board

• Friend of Baruch $250 to $749
Include your senior’s name on a silver leaf on the donor board

• Baruchian Supporter $50 to $249
Include your senior’s name on the Advisory tag on the donor board

Email address *
Yes! I'd like to donate. *
Child’s Name as you would like it to appear on the plaque *
Your answer
Your name *
Your answer
Your email *
Your answer
Your phone number
Your answer
Your address
Your answer
A copy of your responses will be emailed to the address you provided.
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