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Thank you for becoming a Friend of the Friends of County Parks & Recreation Inc. Fill out the form below and send back via email to m.clements1@verizon.net or visit our website www.friendscountyparkshc.com. All checks need to be made out to: Friends of the County Parks. Please let us know if you wish to pay via credit card and we will send you a PayPal link. Friends of the County Parks is a 501-c3 (EIN #9-3088915). Name _________________________________________________ Date____________________ Address__________________________________ City_______________ State______ Zip__________ Type of Donation: __________ Individual ______ Corporate ______ Non Profit Designation of Donation: _______ General Fund _______ Designated Park or Recreation Center or Program Name of Park, Recreation Center or Program_________________________________________________________ Designated Memorial Item: ______________________________________________________________________ Individual Donations: ______ Anonymous Amount: ______________ ______Friend $25 year ______Friend Advocate $50 year ______Friend Sponsor $100 year Corporate Donations: ______Business Friend $500 (Name on website) ______Business Sponsor $1,000 (Name on website and plaque at designated park) ______Business Adopt a Park $2,500 (Name on website, plaque at designated park and flyer material) ______Business Benefactor $5,000 (Name on website, plaque at designated park, flyer material and banner at special events at park) ______Business Champion $10,000 (Name on website, plaque at designated park, flyer material, banner at special events at park and name on monthly newsletter) Solicitation Disclosure Statement Registration #CH6738. A Copy of the Official Registration may be obtained from the Division of Consumer Services by calling toll free with the State. Registration does not imply endorsement, approval, or recommendation by the State. Toll Free: 1-800-435-7352. Website: www.FloridaConsumerHelp.com FRIENDS OF THE COUNTY PARKS & RECREATION DEPARTMENT INC DONATION FORM