Donation Form

M - I Community Foundation

of Monmouth and Independence, Oregon

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How to make a donation: simply use this printable form for donations by check.

_____I want to know more. Please have a Foundation representative contact me.

_____Enclosed is a $__________ contribution to the Foundation.

I want this money to be: _____Placed in the endowment fund

_____Used as needed.

I direct that my contribution be used to support (check):

______Scholarships _____Classroom Enrichment ______Independence Public Library

______Monmouth Public Library ______Independence Heritage Museum

______Monmouth 2056 Bicentennial

______Unrestricted

My Name: _____________________________________________________________________

My Address: _____________________________________________________________________

Telephone (day) __________________________

(evening) ___________________________________

Mail to: Monmouth-Independence Community Foundation

PO Box 368

Monmouth, OR 97361

Phone: 503-838-0251