Individual Giving Form

 

Please fill out the form below, print, and mail along with your tax deductible check to:

Diversity Council

1130-1/2 7th St NW, Ste 204

Rochester MN 55901

 

Name:

Address:

City:

State:

Zip:

Telephone:

Email:

Referred By:

Pledge Amount:

$25 - Contributor

$50 - Bronze

$100 - Silver

$500 - Gold

$1000 - Platinum

Other

     

I am interested in volunteering with the Diversity Council

I would like to receive the Diversity Council's monthly email newsletter.

I prefer not to receive the Diversity Council newsletter.

I would like this gift to be anonymous.