Donation Form

Please print this page, fill it out, and mail it along with your donation to:

ACCESS College Foundation
7300 Newport Avenue
Suite 500
Norfolk, VA 23505

Date: ___________________________

Name:_______________________________________________

Address: ____________________________________________

City: _______________________________________________

State: _______________  Zip Code: _____________________

Yes! I want to partner with the ACCESS Program and help young people go to college.

Enclosed is my tax-deductible donation of:

$30  $50  $150  $500  $1,000  $1,500  2,500  Other $_________

 
Signature: _________________________________________________

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