Pay it Forward Donor Information Survey

1.Contact Information(Required.)

Name

Company

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Cell Phone Number

2.As A DONOR... (click all that apply)(Required.)

I plan to contribute this amount annually.

I would like my contribution to be anonymous.

I am interested in becoming a Mentor to a Pay It Forward Fund recipient.

My contribution is NOT from a Foundation.

My contribution is from a Foundation. Donor Foundation listed below:

If you would like to recommend an existing member to receive funding please contact us, sphillips@greensboro.org.