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JOE D. PENTECOST FOUNDATION

 Donation Application

Organization Name:________________________________________________________Address:______________________________________________________

City:_________________________________________________________

State:_____________________Zip:______________

           

Contact:______________________________________________________

         

 Phone:__________________

 Email:__________________

 OtherInformation:_____________________________________________

 

                                _____________________________________________

 

Donation Amount:___________________

                 

Date Given:_________________________

 

If you would like to give specifically to “Joe’s Kids”please let us know on your application.

Thank you Smile

Please print and fill out the application then mail, email or fax to (517-336-5882) the Pentecost Foundation Att: Rita Stoskopf.

Please allow 30 to 60 days for your application to be reviewed.