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SAME Wounded Warriors
QL+ Universal Lift Program Contribution Form

The QL+ Universal Lift Program funds the development of adaptive technologies to support wounded veterans. Your donations will allow wounded Veterans and other disabled individuals to work as heavy machine operators in fields such as construction, agriculture, waste management and transportation. To find out more about this program, click here.

Please make a selection to donate to the QL+ Universal Lift Program:
Titanium: $5,000
Platinum: $2,500
Gold: $1,000
Silver: $500
Bronze: $250
Other: $249 or less (enter dollar amount below)
Donor amount less than $250. (choose fund above)
Total
Name of Individual or Organization: *
Mailing Address: *
Telephone Number: *
Email Address: *
Name of person completing this form: *

If you experience difficulties with this form, please contact SAME Staff Accountant Katreana Jackson at 703-549-3800 ext. 131, or kjackson@same.org.

If paying by check, please complete the PDF form and mail it, along with a check made payable to the SAME Wounded Warriors Task Force QL+ Fund to

Mail to: SAME
ATTN: Wounded Warrior QL+ Fund
607 Prince Street
Alexandria, VA 22314
By fax:
703-684-0231