Birmingham Falls Foundation
Parent Give-Back Form
Contributor:
Name
Phone Number
Email (this email will be used for receipt purposes)
Address:
Address line 1
Address line 2
City, State and Zip
Participation Levels:
Sponsor
$125
Donor
$250
Patron
$500
Acknowledgement in the School Newsletter
X
X
X
Installation of an engraved 4” x 8” red brick in the school courtyard with 2 lines of personalized messages, up to 18 spaces per line
X
Installation of an engraved 8” x 8” marble paver in the school courtyard with 4 lines of personalized messages, up to 18 spaces per line
X
Invitation to a special “Patrons and Partners” social event with School Administrators
X
Participation
Level:____ Sponsor ____ Donor ____
Patron Total Amount: $_____________
(Please indicate the number of contributions per level and provide total dollar amount of all contributions)
(
) Visa ( ) Master
Card ( ) American Express
Credit Card # _______________________ Expiration Date: ____/____ Security Code:__________
Name on Card: ______________________ Signature: ___________________________________
Billing Address (if different than above):______________________________ State:_____ Zip:_____
If paying by check (we are unable to accept cash) please make payable to “Birmingham Falls Foundation”.
Check #______________
Please complete the donation form and send to the following address:
Birmingham Falls Foundation
980 Birmingham Road
Suite 501-333
Milton, GA 30004
Thank you for your contribution! Installation
of bricks and pavers will take place in the fall. A BFF
representative will be in contact prior to installation to coordinate
your personalized message. Should you have any questions about
the donation program please feel free to contact Ira Weinstein (770)
408-0460, or Stephanie Butler, (678) 393-1127.
Please send to Birmingham Falls Foundation, 980 Birmingham Road, Suite 501-333, Milton, GA 30004
