Donation Form

Name ________________________________________________

Company _____________________________________________

Address ______________________________________________

Phone (__________)__________________________________

E-mail ______________________________________________

Suggested Donation Amounts

( ) $25.00-$97.00 Friends of REACH!

( ) $98.00 REACHing for Excellence

( ) $100.00-$299.00 Bronze

( ) $300.00-499.00 Silver

( ) $500.00-999.00 Gold

( ) $1000.00 & above Platinum

*We must raise at least $100,000

Make checks payable to:
REACH! USA, Inc.

Please send your tax-deductible donation to
REACH! USA, Inc. P.O. Box 1311 Carlisle, PA 17013