$100___ $150___ $200___ $225___ Other___

__Weekly __Biweekly __Monthly __Quarterly

I wish to make a one-time donation of: $ ________________

Name: _____________________________

Address: ___________________________

City______________________ State ___________

Zip___________________

Phone: _____________________

E-mail: _____________________

-----------------------------------------------------------------------Method of Payment

Cash, Check or Money Order Payable to: HMG Enrichment & Dev. Corp.
Your gift donation is tax deductible. Please Print, complete, tear off and keep this portion for your records.

Amount of pledge/donation: ______________________
Date(s)

H. M. Grissom Enrichment and Development Corporation P.O. Box 04073
Detroit, MI 48204

 Print This Page