Scholarship Fund Donation

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$10.00

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Minimum is $10. Use the Quantity button to increase the donation amount in $10 increments.

Scholarship Fund Donation Select all that apply Donation Amount

For each person included in this donation payment, please provide: First Name, Last Name, (Maiden Name if married), DHS Class Year *

Address - Street Number and Name or PO Box [i.e. 123 Main St or PO Box 100] * Maximum of 50 characters

Address - City, State and Zip Code [i.e. Dexter, MI 48130] * Maximum of 50 characters

Email Address [i.e. name@xyzmail.com] Maximum of 50 characters

Phone Number - include area code and type (land line, cell, cell w/text) [i.e. 123-456-7890, land (or cell or text)] Maximum of 30 characters

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