GAC Donation Form

Name:

Phone:

Address:

Address:(continued)

City:

State / Province:

Postal Code:

Country:

A gift from you will help in so many ways.  It will enable members to work at our club or

in the community, and help members find suitable housing so that they maintain their 

independence and have active work and social lives.

I want to support the programs of Grand Avenue Club, enclosed is my donation of:

$100 $50 $35 $25 Other                    

Please make checks payable to:
Grand Avenue Club

Please charge my Visa / MasterCard  (Circle)

Account Number                                                                     Expiration Date                                       

Name                                                                                                                                                     

Address                                                                                                                                                 

City                                                              State                                       Zip                             

Your contribution is tax deductible as allowed by law.

Thank you for your support!

I would like my contribution...

In memory of                                                                                                                                     
To commemorate                                                                                                                               

... and send an acknowledgement to:

Name                                                                                                                                                     

Address                                                                                                                                                  

City                                                              State                                       Zip                             

Please mail to:
Grand Avenue Club

210 E. Michigan Street

Milwaukee, WI  53202-4901

USA

Thank You