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Please Print Clearly:
FIRST NAME: ______________________________________ LAST NAME:__________________________________________
ADDRESS__________________________________________________________________________________________________
Street City/State Zip Code
TELEPHONE NO:________________________________________CELL:_______________________________________________
E-MAIL ADDRESS:___________________________________________________________________________________________
I AM MAKING A CONTRIBUTION TO THE GENERAL FUND IN THE FOLLOWING AMOUNT: $_____________.
MY CONTRIBUTION IS BEING MADE: By Cash ______; OR By Check ______ Check No: ______
_____________________________________________________________ ________________________________________
Signature Date
CONTRIBUTIONS TO THE YWCJCC In that the YWCJCC is a non-profit organization under the Internal Revenue Service Regulation 501(c)(3), all contributions are tax deductible. Upon receipt of the contribution, the YWCJCC will issue a letter to the contributor listing the amount and date of the contribution for the contributor's tax records. This Form may be printed off your computer and submitted by mail. |
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| Yes We Can Johnston County Coalition, Inc. A Coalition of Concerned Citizens |
| What we do by ourselves matters; What we do together really makes the difference. |
| Make Check payable to: YWCJCC Mail Check and Contribution Form To: Kristin M. Williams, Secretary YWCJCC 2121 Powell Drive Clayton, North Carolina 27520 |
GENERAL CONTRIBUTION FORM