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Your Personal Information:

Name: *

How would you like your name(s)to appear?:

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Primary mailing address:		Other mailing address:
Street/PO Box:	*	Street/PO Box:
City:	*	City:
State:	* Zip: *	State:	Zip:
Phone:	*	Phone:
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* - Required Fields

Suggested donation levels for Operational Support:

	$10,000+

$5,000 - $9,999	$2,500 - $4,999	$1,000-$2,499

$500 - $999	$250 - $499	$100 - $249


Donation Details:

Unrestricted Contribution in the amount of: $

Contribution to Named Fund: in the amount of: $

Total contribution: $

My Contribution is ( in memory of ) ( in honor of ):


Please send an acknowledgment to (include name and address):

Please contact me about my options for planned giving

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The Community Foundation for Nantucket is a 501(c)(3) nonprofit corporation. Contributions are deductible to the full extent of applicable tax regulations. Advice from your tax and legal advisors is recommended.

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