Please complete and return this form to the NAILBA Charitable ...
As many of you read in the January 19 edition of NAILBA Now, we were saddened to share the passing of NAILBA’s first Executive Director, Charles D. “Chuck” Rumbarger. Because of his outstanding contributions to his local community, to NAILBA, and to the overall brokerage community, Chuck was recognized with the Mooers Award in 1999. Chuck was very fond of NAILBA, a mentor and a role model to many of us, and was very proud of the success that NAILBA became over the years. In honor of Chuck’s impact on our organization and industry, the NAILBA Charitable Foundation will be awarding a onetime grant (the Rumbarger Grant) to a charitable organization that Chuck would have supported.
Please complete and return this form to the NAILBA Charitable Foundation’s office (11325 Random Hills Road, Suite 110, Fairfax, VA 22030 or by fax to 703-383-6942).
Donations received by February 29, 2016 for this one-time grant will be donated to a charitable organization that Chuck would have supported. 2016 RUMBARGER GRANT DONATION FORM $500 _____ $1000 _____ $2500 _____ $5000 _____ Other __________________________ DONOR NAME: _________________________________________________________________________ ORGANIZATION: ________________________________________________________________________ ADDRESS: _____________________________________________________________________________ CITY, STATE, ZIP: ________________________________________________________________________ EMAIL: _______________________________________ PHONE: _________________________ My donation is personal ______
from my organization ______
____ I prefer to be listed as anonymous
CHECK # _______________ made payable to the NAILBA Charitable Foundation is attached. CREDIT CARD: VISA _____ MasterCard _____ AmEx ______ EXPIRATION DATE: ____________ CREDIT CARD NUMBER: _________________________________________________________ NAME ON CARD: _______________________________________________________________ SIGNATURE: ___________________________________________________________________ For more information about the NAILBA Charitable Foundation, please contact Kathy Allison, NAILBA’s Director of Membership and the Foundation, at [email protected] or at (703) 383-3081. NAILBA Charitable Foundation, FEIN 56-2448850.
Please complete and return this form to the NAILBA Charitable Foundation’s office (11325 Random Hills Road, Suite 110, Fairfax, VA 22030 or by fax to 703-383-6942).
Donations received by February 29, 2016 for this one-time grant will be donated to a charitable organization that Chuck would have supported. 2016 RUMBARGER GRANT DONATION FORM $500 _____ $1000 _____ $2500 _____ $5000 _____ Other __________________________ DONOR NAME: _________________________________________________________________________ ORGANIZATION: ________________________________________________________________________ ADDRESS: _____________________________________________________________________________ CITY, STATE, ZIP: ________________________________________________________________________ EMAIL: _______________________________________ PHONE: _________________________ My donation is personal ______
from my organization ______
____ I prefer to be listed as anonymous
CHECK # _______________ made payable to the NAILBA Charitable Foundation is attached. CREDIT CARD: VISA _____ MasterCard _____ AmEx ______ EXPIRATION DATE: ____________ CREDIT CARD NUMBER: _________________________________________________________ NAME ON CARD: _______________________________________________________________ SIGNATURE: ___________________________________________________________________ For more information about the NAILBA Charitable Foundation, please contact Kathy Allison, NAILBA’s Director of Membership and the Foundation, at [email protected] or at (703) 383-3081. NAILBA Charitable Foundation, FEIN 56-2448850.
