Tax Credit Donation Form 2012.pdf - Camp Verde Unified School

							                                 Camp Verde Unified School District
                                               2012 State Tax Credit Donation

Name:                                                                                                 Home Phone:

Address:

City:                                                                           State:        AZ               Zip Code:

Signature:

      Camp Verde Elementary School                                                       Camp Verde High School
             * General Account                                              Student Activities                Woods
                                                               General Account                               Yearbook
        Camp Verde Middle School                               Agri-science
 General Account             FFA Pals                        Art—(Ceramics, Photo & Other Art)                      Athletics

                                                               Astronomy                                                Baseball
 Athletics                   Builders Club
                                                               Auto                                                     Boys’ Basketball
      Athletic General        Student Council
      Football                                                 Class of __________                                      Girls’ Basketball
                              National Honors                                                                           Cheer
      Cheer
                                    Society                    Culinary Arts
      Cross Country                                            Digital Media                                            Cross County
                              Yearbook
      Volleyball                                               Music                                                    Football
      Basketball                                                                                                         Golf
                                                               Physics
      Baseball                                                                                                           Softball
                                                               Positive Student Reinforcement
      Soccer                                                                                                             Boys’ Soccer
      Softball                                                 Student Council
                                                               Spanish Club                                             Girls’ Soccer
      Track
      Wrestling
                                                                                                                         Track


Any amount of donation is greatly appreciated. The state allows a $400.00 credit for                South Verde Technology Magnet
married couples filing jointly and a $200.00 credit for individual contributions to enhance
students’ education and extracurricular programs. You may choose to direct your contri-
                                                                                                           School * General Account
bution to any of the programs listed above. Please designate where you would like your
                    donation applied. Thank you for your contribution.                            For your convenience, you may send one check
                                                                                                 and designate programs in each building. We will
 1.                                                                   $                           forward the dollars on to the individual buildings.

                                                                                                   Please mail checks or deliver them payable to:
 2.                                                                   $
                                                                                                                CVUSD Tax Credit,
 3.                                                                   $                                        410 Camp Lincoln Rd.
                                                                                                              Camp Verde, AZ 86322
 4.                                                                   $
  If you don’t see the class or activity where you would like to designate your donation,
                                                                                                         A receipt will be forwarded to you.
                         please write it in one of the spaces above.
                                                                                                         Questions? Please call 567-8008