Scholarship Fund Donation

Please print this page, complete the information, and mail your donation to:

P.O. Box 6008
Penacook, NH 03303

Donor Name __________________________________________________________
Address __________________________________________________________
City/State/Zip __________________________________________________________
Telephone __________________________________________________________
E-mail __________________________________________________________


Please accept my/our gift as follows:

$76    Two days at camp
$99    Three days at camp
$140  One week at camp
$280  Two weeks at camp
____  Other

Please make checks payable to Penacook Community Center

Additional Information:

___ I wish to receive future e-mail correspondence
___ I prefer to make donations anonymously
___ This donation is on behalf of a company ______________________________
___ This donation is in memory of _______________________________________

How did you hear about PCC?

  ___ Referral   ___ Flyers ___ Newspaper/Radio ___ Website ___ Other  

Please return this form to: Penacook Community Center  P.O. Box 6008 Penacook, NH 03303

Return to Main Donation Page