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You are about to join …

... an exclusive group of people that
believe in and contribute to support the
Southern Nevada Chapter of SCORE!

(You may print, fill out, and mail or fax this form. This page is print friendly.)

SCORE is a non-profit organization under Section 501(c)(3) of the US Internal Revenue Code.
All gifts are acknowledged by letter at the end of the year.
Please accept my donation


Name________________________________________________________________________

Email_______________________________________________________________________

Address_____________________________________________________________________

City________________________State______Zip___________Phone__________________

Enclosed is my check in the amount of:$____________

My Employer _____________________________________________ will match my gift.

         I am enclosing will send a matching gift form.

My name as I would like it to appear in print:______________________________

I prefer to give anonymously; please do not use my name.

This is the first time.   I am renewing my support.

I am giving this gift in honor and recognition of:

__________________________________________________


Friend     $25-$99
Associate  $100-$249
Patron     $250-$599
Sponsor    $600-$1999
Benefactor $2000 and above

Please send or fax to:
SCORE Southern Nevada Chapter 243
City Centre Place, 400 South 4th Street
Suite 250A, Las Vegas, NV 89101
Fax: 702-388-6469

Phone: 702-388-6104
E-mail: scorelv@coam.net
Web site: www.scorelv.org

Thank you for giving of yourself for such a worthwhile cause!