Nathanael Greene Monument Foundation
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 To Make Your Donation by CHECK:

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To make contribution by check, simply print and fill out this page. All those who donate $100, or more, will receive, in recognition of their generosity, a Certificate of Appreciation from The Foundation. Mail this form together with your check made payable to:

Nathanael Greene Monument Foundation, Inc.
C/O Charles M. Vacca, Jr., Treasurer
124 Fairway Drive
Coventry, RI  02816-5780
The Nathanael Greene Monument Foundation, Inc. is a non-profit organization, incorporated in the State of Rhode Island.  We are pleased to announce that, as of February 28, 2014, our status as a qualified 501(c)(3) tax-exempt non-profit organization has been approved by the US Internal Revenue Service, with a retroactive effective date of August 15, 2012.
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Enlist in General Greene's Army !
Yes, count me in!
I would like to make a tax-deductible donation to the Nathanael Greene Monument Foundation, Inc. in order

to help this important project become a reality...
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NAME: ______________________________ E-mail: _________________________
STREET ADDRESS: ____________________________________________________
CITY/TOWN: _______________________ STATE: ______ ZIP+4:________-______

DONATION AMOUNT: __________________ YOUR CHECK #: __________________
All sponsor and paving block orders must be prepaid in full.  Checks only, no cash.
MAJOR SPONSORSHIP CATEGORIES
___  $10,000 - Army     - Flagpole, 30-foot tall with an engraved plaque.
___      5,000 - Division - Park Bench, 6-foot metal/composite with plaque.
___      2,500 - Artillery - Bicycle Rack, 7-unit capacity, metal with plaque.
ENGRAVED PAVER BLOCK PROGRAM
___    $1,000 - Brigade    - 24x24-inch engraved paver with up to 300 characters.
___         500 - Regiment - 16x16-inch engraved paver with up to 120 characters.
___         250 - Battalion  - 8x16-inch engraved paver with up to 60 characters.
___         125 - Company  - 8x8-inch engraved paver with up to 27 characters.
Requested Inscription:____________________________________
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* Inscriptions subject to approval by the Board of Directors for appropriate content.
Block lettering, condensed 1x¾-inch size, with black lithochrome tinting will be used.
-= OTHER SUGGESTED CONTRIBUTION LEVELS =-
___ $100; ___ $75; ___ $50; ___ $25; or, Other donation amount  $_______
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  Nathanael Greene Monument Foundation, Inc.  ●  164 Gough Avenue, Coventry, RI  02816-7515

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