VISA MASTERCARD

DONATION FORM CSCL GYMNASIUM CAMPAIGN YES, AL , I will help you make a difference in a young person’s life by my tax-deductible contribution. ONE TIME GIFT OF $10,000 $5,000 $2,500 $ OTHER MONTHLY CONTRIBUTION OF $500 $100 $50 $ OTHER GIVE BY CREDIT CARD VISA Master Card AMEX Expiration Date CARD NUMBER Signature Your Name Address City DISCOVER State Zip Code Telephone Email Address GIVE BY CHECK (PAYABLE TO): Comenius School for Creative Leadership or CSCL Attn: Accounting - Gym 375 Star Light Drive Fort Mill, SC 29715