Make a Contribution Today! Link to Downloadable: Commitment Form Help Support Our Lifesaving Work
The Wisconsin School Safety Coordinators Association is the only charitable organization that dedicates 100 % of its time and resources to the task of improving safety, health and wellness in Wisconsin’s schools. 1. Product Contribution (For use in our Silent Auction): _____Yes, count me in as a WSSCA contributor. Product Donation Description: _____________________________________________________ Value of Product Donation: $ _____________________ _____ I will ship the product to WSSCA
_____ I would like WSSCA to call me about picking up or shipping instructions 2. And/or Financial Contribution Levels: ____ Diamond Sponsor $5,000
____ Platinum Sponsor $2,500
____ Gold $1,000
____ Silver $500
____ Bronze $250
____ Other $____________ Organization Name: _____________________________________ Contact Name: ____________________________Title:______________________ Organization Address: ___________________________________ Phone ________________________________________________ Fax: __________________________________________________ Email: _________________________________________________________
Method of Payment for Financial Contribution:
Total: $_____________
_____Check is enclosed. (Payable to: WSSCA Fed ID #39-1671507)
_____ Purchase Order # _______________________
Authorized Signature __________________________________ Date _____________________
Thank you for your generous support of the Wisconsin School Safety Coordinators Association. Please return this form to: Wisconsin School Safety Coordinators Association
PO Box 210290
Milwaukee, Wisconsin 53221-5008 Peter Pochowski, Executive Director, WSSCA
Phone: 414-559-7487
Fax: 877-282-4860
Email: wssca@wssca.org |
