fair-share-invoice-receipt by welcomegong1

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									                                                        INVOICE/RECEIPT

                                             PERSONAL DONATION CATEGORIES
                               $ 10 - $ 49 ............................... ASPIRE Friend
                               $ 50 - $ 99 ............................... ASPIRE Advocate
                               $100 - $149 ............................... ASPIRE Council
                               $150 - $199 .............................. ASPIRE Patron
                               $200 - $499 ............................... ASPIRE Champion
                               $500 and Above .............................. ASPIRE Benefactor

You are invited and encouraged to make a Personal Donation and pay the Project Membership to ASPIRE. Please
complete the information below, retain a copy for your records, and mail this form and your contribution to:

                                                                       ADDRESS OF CONTRIBUTOR

Carol Gritts                             RuthAnne Shope                Name_________________________________________
Upward Bound Unit 9516                   Upward Bound
1200 University Street                   1300 West Park Street         Program_______________________________________
Black Hills State University             Montana Tech
Spearfish, SD 57799-9516                 Butte, MT 59701               Institution______________________________________
Telephone: 605-642-6120                  406-496-4693                  Address_______________________________________
Fax: 605-642-6282                        406-496-4696
Email: CarolGritts@bhsu.edu              rshope@mttech.edu             _____________________________________________

                                                                       _____________________________________________

                                          ************************************************
                                                               2004
                                             (September 1, 2004 through August 31, 2005)

Project Membership: $_________________($100.00)                                         Personal Donation: $_________________

          Please make Check(s) payable to ASPIRE
          Credit Card Payment:          American Express       Visa      MasterCard         Discover       Other___________________

          Account Number:___________________________________ Expiration Date:__________________________

          Billing Address:____________________________________________________________________________
                           Street Address/Box Number                             City                         State         Zip Code


          Signature:______________________________________________

                                      TOTAL SUBMITTED                                                  $

             Thank you for your personal commitment to ASPIRE and its TRIO programs and students.
PLEASE NOTE:

_______ Check here if you do not wish to receive a token of appreciation for your donation.

								
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