Donation Form

Columbia Gorge Center

Donor Information
Name:
Billing Address:
City:
State:
Zip Code:
Telephone (Home):
Telephone (Business):
Fax:
E-mail:
Pledge Information
I (we) pledge a total of $ to be paid: now monthly quarterly yearly. I (we) plan to make this contribution in the form of: cash check credit card other.
Credit Card Type:
Credit Card Number:
Expiration Date:
Authorized Signature:
Acknowledgement Information
Please use the following name(s) in all acknowledgements: I (we) wish to have our gift remain anonymous. Name(s): Date:
Please make checks, corporate matches, or other gifts payable to: Columbia Gorge Center 2940 Thomsen Road Hood River, Oregon, 97031 Go to file menu at the top of your screen, select print, choose a printer, and hit print.