Deerfield Park Foundation –Involvement/Donation Form 2013 To donate online please visit www.deerfieldparks.org. Or, return form to: Deerfield Park Foundation, 836 Jewett Park Drive, Deerfield, IL 60015. You may attach/email back the form to darla@dfpd.org; or, if paying by credit card, fax to: 847-945-0699. Make checks payable to Deerfield Park Foundation. This Foundation is a 501(c)(3) nonprofit, nongovernmental entity. Contributions may be deductible under IRS regulations. Name____________________________________________ E-mail ____________________________________________________ Phone: Home:_____________________________________ Cell:____________________________________________________ Address/City/Zip ___________________________________________________________________________________________ Business (if applicable)_______________________________ Phone ___________________________________________________
Please accept my donation toward: • "Be a Dear" (Grants-in-Aid): (financial assistance for those in serious financial need to participate in DPD programs). Indicate exact amt. Please list contribution: Gold ($500+) $__________ Silver ($100-499) $__________ Partner ($75-99) $_________ Friend ($50-74) $__________ Patron ($25-49) $__________ Deer ($24 and below) $__________ • Linda Gryziecki Scholarship: (for current/recent H.S. grad./college student to use toward Post-Secondary/College tuition 2013-'14 Please enter amount of your contribution: $____________
• GENERAL DONATIONS: for projects, such as, Green Initiatives, Recycling Containers, Accessible Equipment, ThorGuard Lightning Predication
System upgrades & MORE! Please list Project: ____________________________________________ & amount of contribution: $_____________
Please accept my order for the following engraved item(s): ___ Donor wall name plate at Sachs Recreation Center: $50 each for ____ # Name Plates = $___________ (Max.: 3 lines; 22 characters/line) ___ woodland park: 5˝x10˝ pavers: $70 each for ____ # Pavers = $___________ (Max.: 3 lines; 16 characters/line) ___ woodland oversized/family pavers: 10˝x10˝ pavers: $135 each for ____ # Pavers = $___________ (Max.: 7 lines; 16 characters/line) ___ deerspring pool: 4˝x8˝ pavers $50 each for ____ # Pavers = $___________ (Max.: 3 lines; 12 characters/line) ___ mitchell pool: 4˝x8˝ pavers $50 each for ____ # Pavers = $___________ (Max.: 3 lines; 12 characters/line) ___ DOG BONE at Jaycee Park: $30 each for ____ # Dog Bones = $___________ (Max.: 3 lines; 15 characters/line) ___ RECYCLING CONTAINER for DFPD Location: $750 each for ____ # Recycling Containers = $___________ (approved business name on slat) Be sure to include wording with order. For your convenience, you may enter your desired wording in the appropriate boxes provided on the next page and return with this form. Please note: the maximum # of characters per line includes letters, spaces and punctuation. To make a Tree Donation (w/engraved leaf mounted on Donor Wall at Park District facility involved) or Bench Donation (w/engraved plaque): Please call 847-945-0650 or email: info@dfpd.org. You may also visit the Foundation's website at www.deerfieldparkfoundation.org. IMPORTANT NOTE: Additional procedures and policies may apply and will be sent if needed.
I would like to be a sponsor, donor or participant, Please CONTACT ME ABOUT: ___ Park & education golf outing (Spring) ___ Moonlight Golf (September) ___ community services day (September) ___ other (please list):____________________________________________________________________________________________________
Payment Type: ___CASH ___CHECK ___CREDIT CARD: Circle one: Visa MasterCard Discover CARD #_______________________________________ Expiration Date___________ Total Amount ENCLOSED: $_________________ Date:_______________ Signature:__________________________________________________
Winter/Day Camp 2013
register.deerfieldparks.org • 847.945.0650
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