Contribution Form

YES, I would like to make a charitable contribution in the amount of

$ ______________________.

Mail completed form with check or credit card information to:

Veterans Memorial Park Fund

of Abingdon/Washington County, Virginia, Inc.

P. O. Box 571

Abingdon, VA 24212

Name: ________________________________________________________

Address: ______________________________________________________

______________________________________________________

City: ___________________________ State: _______ Zip: ____________

Email Address: _________________________________________________

Method of Payment:

o Enclosed Check No. _____________ dated on _____________________

o Charge: _______ Visa _______ Mastercard

Card No. _________________________________________________

Expiration Date: ___________________________________________

Cardholder’s Name: ________________________________________

Signature: ________________________________________________