CONTRIBUTION
RECORD
DATE: _____/_____/__________
COMMITTEE / BUDGET CATEGORY:
_________________________________ AMOUNT: $___________
_________________________________ $___________
_________________________________ $___________
_________________________________ TOTAL: $___________
COMMITTEE
CHAIR NOTIFIED OF CONTRIBUTION:
CHAIR___________________________ DATE NOTIFIED ________
DESCRIPTION
OF CONTRIBUTION:
(Please attach invoice, receipts, etc.)
PERSON
TO BE ACKNOWLEDGED FOR CONTRIBUTION:
NAME: ________________________________________
STREET: ________________________________________
CITY & ZIP: ________________________________________
______I
do not need an acknowledgement, but please record the value of
my contribution for your
records.(If you check this statement, please do not give
this form to the treasurer. Give it to the chair of the committee you donated
to.)
SIGNATURE: ________________________________________