The Community Foundation of the Virginias, Inc.

              (Print out this page, fill it out, and mail it in with your check)

You will find enclosed $ ________________________

As a gift from ________________________________________________

                           Print your name as you would like it to appear in Foundation publications

___________________________________________________________

Address                                                               City                                            State             Zip

�  Please apply this gift to Unrestricted Funds.

� Please apply this gift to the following Field-of-Interest or Endowment Fund

      _______________________________________________________

� Please apply this gift to offset administrative expenses.

 

Please apply this gift:

� In memory of ______________________________________________

� In Honor of ________________________________________________

� As a Contribution ____________________________________________

� Without reference to the amount

� Please send additional information on establishing a named Endowment Fund.

 

Make your check to: The Community Foundation of the Virginias, Inc.

                                           PO Box 4127

                                           Bluefield, WV 24701