Donors

Yes, I want to help make Play accessible for all children in Essex!

Print Out This Form, Fill It Out and Mail It Today!

Donations of $50 or more will be recognized on an onsite donor plague according to the following categories: $50-$149; $150-$499; $500-$999; $1,000-$4,999; $5000-$9,999; $10,000 and above

Name______________________________________

Address __________________________________________________________________Zip________________

Phone_____________________________________

I have enclosed a check for $_______________

made out to: EES-PTOPlayground Fund, c/o Essex Elementary, 108 Main Street, Centerbrook, CT,06409

Name as it should appear on recognition sign (for donations of $50 or more):

__________________________________________
(please print clearly)