DONATION INFORMATION

***PRINT out this page, WRITE in your information and MAIL it with your donation to:

***Make check payable to:

CHAUTAUQUA REGION COMMUNITY FOUNDATION (TROLLEY FUND)

DONATION FORM

I would like to make a donation in the amount of $___________ to the Chautauqua Region Community Foundation Jamestown Street Railway Trolley Car #93 Restoration Fund.

NAME: __________________________________________

ADDRESS: _______________________________________

_________________________________________________

PHONE:(optional) _________________________________