Georgia 4-H Foundation Hoke Smith Annex University of Georgia Athens, GA 30602-4356
Rock Eagle 4-H Center • 350 Rock Eagle Road NW • Eatonton, GA 31024 706-484-2800 • Fax 706-484-2888 • email@example.com
The University of Georgia and Ft. Valley State University, the U.S. Department of Agriculture and counties of the state cooperating. Cooperative Extension offers educational programs, assistance and materials to all people without regard to race, color, national origin, age, sex or disability. An equal opportunity/affirmative action organization committed to a diverse work force.
Detach and return to Georgia 4-H Foundation, 306 Hoke Smith Annex, Athens, GA 30602 Are you Georgia 4-H? Help us Create a Hope for Tomorrow, for our Youth Today.
Name :___________________________________________ Address: _________________________________________ City: _____________________ State:______ Zip: ________ Email: ___________________________________________ Phone: __________________________________________ Birthdate(s)_______________________________________ I would like to designate my gift to: ____________________ ________________________________________________
____ Please contact me about planned giving opportunities. ____ I have enclosed my company’s matching gift form. ____ I am a UGA employee interested in a payroll deduction.
I am Georgia 4-H! I want to offer my support! Enclosed is my gift of: t $1,000 t $500 t $250 t $100 t $50 t $25 t Other _________ Payable as one of the following: t Check (payable to Georgia 4-H Foundation) t Credit Card Card Number: _____________________________________ Expiration Date: ____/____ 3 or 4-digit CS Code: ________ Signature: ________________________________________ t I want to make an ongoing pledge to support Georgia 4-H. Please charge my credit card at $_____ per month for _____ months.
(Gifts may also be made online at www.georgia4hfoundation.org
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