Yes, I want to take control of how my state income tax dollars are spent and provide
financial aid for our future leaders!
Name__________________________________________________________________
Address_________________________________________________________________
City_______________________________________, AZ Zip Code________________
Phone #______________________________
E-mail Address_________________________
Donation amount enclosed/charged $_____________________
(Maximum donation is$500 for single or head of household. Maximum is $1000 for married taxpayers filing joint returns)
Please designate my donation to
Check enclosed payable to White Mountain Tuition Support Foundation
Visa MasterCard Discover
Card number____________________________________
Expiration Date__________________________________
Signature_______________________________________
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