Burgettstown Area Scholarship Foundation (basf) Registration/Contribution Form Major Donor Recognition Program



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Burgettstown Area Scholarship Foundation (BASF)

Registration/Contribution Form

Major Donor Recognition Program
True Blue Devil - Over $1,500.00 contribution to BASF

Donor will receive: Recognition in the Dinner Program

Four dinner tickets

12 x 12 Brick on the Hill Stadium Walk of Fame



Blue Level - $1,000.00 to $1499.00 contribution to BASF

Donor will receive: Recognition in the Dinner Program

Two dinner tickets

8 x 8 Brick on the Hill Stadium Walk of Fame



White Level - $500.00 to $999.00 contribution to BASF

Donor will receive: Recognition in the Dinner Program

4 x 8 Brick on the Hill Stadium Walk of Fame

RESCHEDULED Dinner at 7:00 on October 10, 2014 (Doors Open at 6:00)
If you are not able to attend, please consider supporting the Foundation with a contribution

Please complete and detach the form below to order tickets or make contributions


________________________________________________________________________


2014 Burgettstown Area Scholarship Foundation Dinner
Name ___________________________________ Year of Grad. ____________
Address _________________________________________________________________
High School Activities ______________________________________________________
________ Dinner Tickets @ $35.00 each $ _____________
Additional Contribution to the Scholarship Foundation $ _____________
Total enclosed $ _____________

Checks should be made payable to BASF and sent to:


Jon Vallina

PO Box 152



Langeloth, PA 15054 Phone - 724-947-2898

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