Name: _________________________________________________
Address: _________________________________________________
_________________________________________________
Donation to:
□ Culton–Peerman Stadium PA amount = $ ___________
□ Performing Arts Keyboards amount = $ ___________
□ PTSA Giving Campaign amount = $ ___________
Would you like your name listed as a donor? YES NO (circle one)
Do you want a tax receipt & acknowledgment? YES NO (circle one)
Employer (if matching donations available): _________________________________________________
Make checks or money orders payable to:
CHHS Athletic Booster Club
CHHS PALS
and/or Chapel Hill High School PTSA 2011-2012 Giving Campaign
Send payments to: CHHS Class of 1972 Class Gift, c/o Robert Anderson, P.O. Box 962, Carrboro, NC 27510.