We don’t charge a membership fee and your tax-deductible donation
helps all our Northampton Neighbors.
- One-Time Donation. Your contribution supports people and programs in your neighborhood.
I have included my donation of □ $10 □ $25 □ $50 □ $100 or $______Other
- Ongoing Donation. Become a Long-Term Sustainer of Northampton Neighbors
I have included my donation of: □ $10 □ $25 □ $50 □ $100 or $______Other
Please deduct this amount: monthly or annually (please circle one)
from my bank account beginning on the 15th day of the month of _________ 2019,
and ending when I notify you.
My Bank Account Number__________________________________
My Bank’s Routing Number_________________________________
(Please attach a voided blank check or deposit slip to confirm your routing and account number.)
Name exactly as it appears on my bank account:_____________________________
Signature _______________________________ Date: ______________________
- You can make a One-Time or Sustaining donation on our website:
- Tell me more about:
□ donating securities □ including NN in my estate plans □ In-kind services
- You can also donate your time and skills: Volunteering with Northampton Neighbors is fun and rewarding. Please download a volunteer application at www.northamptonneighbors.org or call (413) 341-0160
Please complete and return this form to:
Northampton Neighbors PO Box 231, Northampton, MA 01061
(413) 341-0160 and email@example.com
Northampton Neighbors (NN) is a 501(c)(3) nonprofit organization 12/18