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Education & Mentoring and QL+ Contribution Form

Please use this secure online form to contribute to the SAME Education and Mentoring (E&M) Fund and the Quality of Life Plus (QL+) Fund. If you prefer, you may click here to download the contribution form as a PDF, and send by mail or fax.

E&M Fund Sponsor (Permanently Restricted Fund; recognition on E&M Fund webpage for the life of the Fund.)

5 Star Sponsor: $25,000
4 Star Sponsor: $10,000
3 Star Sponsor: $7,500
2 Star Sponsor: $5,000
1 Star Sponsors: $2,500
Name of Individual or Corporation:
Mailing Address:
City:
State:
ZIP:
Contact Person:
E-mail Address:

Annual donor to E&M Fund or QL+ (Recognition on web page for year given)

Please Indicate the Fund to which you are donating

 

 

 

Platinum: $1,000 or more
Gold: $500-$999
Silver: $250-$499
Bronze: $50-$249
Pewter: $25-$49

Please enter your Annual Donation Amount in the field to the right.

E&M Fund
QL+ Fund
Both - Equal Amount to each.
Annual Donation Amount
Name of Donor:
Mailing Address:
State:
ZIP:
City:
Telephone Number:
E-mail address:

If paying by check, please make check payable to SAME.

Mail to:
SAME
607 Prince St.
Alexandria, VA 22314-3117

Please contact Katreana Jackson at 703-549-3800 ext. 131, kjackson@same.org.


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