South Bay Historic Chinese American Cemetery Corporation
Donor Information (please print or type):
Name:____________________________________________
Billing Address: _____________________________________
City:_______________________ State: _______ Zip: _______
Telephone (home/business):_________________________________
Other(Fax/Email):_________________________________________
Pledge / Donation Information:
I (we) pledge a total of $________ to be paid:
____now ____monthly ____ quarterly _____annually
I (we) plan to make this contribution in the form of:
____cash ____ check ____other
Gift will be matched by _______________________________(company/family/foundation).
____form enclosed _____form will be forwarded
Acknowledgement Information:
Please use the following name(s) in all acknowledgements:
_________________________________________________________________
__ I (we) wish to have our gift remain anonymous.
Signature:________________________________________ Date: ____________
Please make checks, corporate matches, or other gifts payable to:
South Bay Historic Chinese American Cemetery Corporation
300-A Curtner Avenue San Jose, California, 95125