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| Donation Form |
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| Print, complete and send to Scenic Hudson, Inc., One Civic Center Plaza, Suite 200, Poughkeepsie, NY 12601 |
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A financial contribution to HVPC is the most effective step you can take to help stop the SLC threat immediately.
Please do your part. Add your voice by joining us in saving the Hudson Valley, Berkshire County and the Northwest Corner as we know them today and for future generations.
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Name: | __________________________________ |
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| Address: | __________________________________ |
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| City: | __________________________________ |
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| Zip: | __________________________________ |
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| Phone: | __________________________________ |
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| E-mail: | __________________________________ |
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I would like to support the coalition by making a donation of:
 | $500 |
| $1000 |
| $5,000 |
| $10,000 |
| ________ |
| | My check is enclosed (make checks payable to Scenic Hudson, Inc.) |
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| | Please charge my credit card |
| Visa |
| MC |
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| | Credit Card #:____________________________ |
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| | Expiration Date #:_______/_______/_______ |
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For further information:
Contact Janice Holzman at (845) 473-4440, ext. 111, or e-mail jholzman@scenichudson.org. |
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