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PLEASE CHECK THE APPROPRIATE BOX:

I wish to become a Supporting Member.
I enclose my annual membership fee of $125.00

I wish to become a Voting Member.
I enclose my annual membership fee of $250.00

I wish to become a Sponsor Member.
I enclose my annual membership fee of $500.00

I wish to support the renovations of Ongiara College by joining the 7½ Mile Club
and enclose a check/credit card donation of $___________

I wish to support Ongiara Foundation by making a donation of:
$100   $75   $50   $25 Other $__________

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NAME …………………………………….......................................................................

ADDRESS ……………………………….……………………………………………..

Phone number (….………)…………...............................

Email address ……………………………........................

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CREDIT CARD PAYMENTS

Name on card……………………………...........................................

Card No………………………………….............................................

Expiration Date………………...

CVV ……………
(last 3 digits of security code on back of card)

CHECKS

Please make checks payable to : ONGIARA FOUNDATION
and send to the address below

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Please mail this form to:

Ongiara Foundation
187 Hodge Avenue, Buffalo, NY 14222, USA

THANK YOU FOR YOUR SUPPORT!