Capital District Kiwanis Foundation
Contribution Form
Contributions to the Capital District Kiwanis Foundation are tax deductible and support the district's sponsored youth organizations as well as other district projects. Treat yourself or a friend to the honor of a gift of recognition from the Capital District Kiwanis Foundation.
I wish to contribute to the Capital District Foundation as listed below:
1. ______ $150 Contribution - Life Member
Name:__________________________ Club:_______________________
If past or present club officer: Highest Office: _______________ Year:_____
2. ______$100 Contribution - Memorial
Name:__________________________ Club:_______________________
Year of Birth:_______ Year of Death:_______
Next of Kin (to receive plaque):___________________________________
Address:_____________________________________________________
3. ______$1000 Contribution - Tablet of Honor
Name:__________________________ Club:_______________________
4. ______$3 per year per Kiwanian
Name:__________________________ Club:_______________________
5. ______$ (any amount) Contribution - Honoree
Name:__________________________ Org:________________________
(can be anyone, not only a Kiwanian)
6. ______$25 Contribution - Sustaining Member
Name:__________________________ Club:_______________________
If past or present club officer: Highest Office: _______________ Year:_____
7. ______$(any amount) Contribution - Young Children Priority One
8. ______$100 Contribution - Youth Outreach Program
Designate Youth Program (if desired):______________________________
9. ______ $1,000 Contribution - Founder's Society
Name: ______________________________ Club: ________________________ Address: __________________________________________________________
Make checks payable to: Capital District Kiwanis Foundation, Inc.
Send this form and check to:
Charles P. Adams 1601 Charrington Dr. Midlothian, VA. 23113
For questions about donations to the Foundation contact your Division Director.