You may print out this page, completely fill out the form and mail with your check to:
Weymouth Rotary Club
PO Box 52
South Weymouth, MA   02190

or, you can click the Donations Appreciated button to the right and the form will come up in
your Word program.  From there you can fill it out and mail to us.  Thank you.

Donor Commitment Form

 My  Name: _____________________________________________________________

Street Address / PO Box: __________________________________________________

City / State / Zip Code: ____________________________________________________

         I prefer to make my donation anonymously                I would prefer to be contacted via:

Email: __________________________________________________________________________

Phone Number: __________________________________________________________________

Donation
     $250          $500         $750          $1,000          $5,000          $10,000          Other: _______________

      Check Enclosed (made payable and mailed to:  Weymouth Rotary Club,  PO Box 52, South Weymouth, MA   02190

Credit Card:         AMEX           Visa           MasterCard          Discover         Other ________________

Card Number: __________________________   Exp. Date:  _________    Security Code: _______

________________________________________________________                          ________________
Authorized Sponsor Signature (signature indicates acknowledgement of agreement)                      Date

Acknowledgement Information
Gift In Honor or In Memory of: ___________________________________________________________________

Send Notice Card to: ___________________________________________________________________________

Address: ­_____________________________________________________________________________________

From: _______________________________________________________________________________________

I/we will donate funds to the Weymouth Rotary’s Weymouth Family FUNraiser (Walk-Run-Bike on September 18, 2010) hosted by The Weymouth Rotary Club of Weymouth, Mass.  I understand that the net proceeds from this event will be used for charitable organizations at the discretion of the Rotary Club of Weymouth.
Sponsor funds are made payable to the Weymouth Rotary Club.  Sponsorship commitments must be made by July 15, 2010 to be included in advertising and marketing materials developed after September 1, 2010.   Payments are due no later than September 1, 2010.
Organizational logo must be provided to the committee in a camera ready format no later than July 15, 2010.