Grant Cottage Donation Form

Grant Cottage Visitor Center Donation Form
Please print this, fill out and return to Grant Cottage

Please fill out the following

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Your Name(s)

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Address

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City

_________________ ________________ _______________
State Zip Phone

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Email

Please Select a Level
of Donation

  ____ $50 "Grant" for Grant

  ____ $100 Patron

  ____ $250 Sponsor

  ____ $500

  ____ $ 1000 Benefactor

  ____ Other (Amt: $_________ )

  Make checks payable to:

  The Friends of The Grant Cottage
  P.O. Box 2294
  Wilton NY 12831

We accept Visa or Mastercard

________________________________________________ Name (as it appears on card)

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Address (as it appears on card)

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Signature

Type of Card

____ Visa ____ Mastercard

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Card Number

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Expiration Date