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Thank you for your support of Camp Constitution Please use this form to set a continuous support plan in
Reset
support of the Camp Constitution mission.
DONATION FREQUENCY:
Monthly
Annually  Kd
On Specific DaD: ________

AMOUNT OF EACH DONATION:

$25 $50 $100 $250

$500

$1,000

$2,500

Other: $____________

PREFERRED PAYMENT METHOD:

Check Credit Card
I would like to receive a reminder prior to each donation: z Ed
Name: ______________________________________
Company or Organization: ____________________________________________________________
Address: __________________________________________________________________________
City: ___________________________________ State: ______ Zip code: _______________
Telephone: (_____) _____-_________ Business Cell

Home

E-mail Address: ___________________________________________________

Would you prefer to have your donations remain anonymous? YES NO

Thank you for supporting s mission through your generous donations!
If paying by Check - -

If paying by Credit Card VISA

M/C Discover American Express

Please make checks payable to  Name on credit card:________________________________

 and mail to: .
Card#____________________________________________
.

Camp Constitution
Attn: Charles Everett
5945 Quail Hollow Road
Unit D
Charlotte, NC 28210

Expiration Date: ____/______

3-digit code: _______

I (we) authorize Camp Constitution to charge this credit card

in the amounts and on the schedule defined on this form above.
.
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Signature: ________________________ Date:___/___/___

-Questions? For Further Assistance

email Hal Shurtleff: campconstitution1@gmail.com