Polytechnic School Annual Fund

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I am / We are pleased to support Polytechnic School. Founders Willis Stork Virginia Pease Centennial Head of School 1907

$50,000+ ($440 value) $25,000+ ($340 value) $15,000+ ($300 value) $10,000+ ($50 value) $5,000+ ($50 value) $1,907+

Your gift may be tax deductible, less any benefit value. Contributors at the Head of School Club level and above are invited to donor recognition events during the year. A full list of benefits is available at polytechnic.org/donor-recognition

I / We prefer to pay with a credit card. Card Number

Expiration Date

Print name as it appears on credit card

□ □

Gift Amount $_________________ (Please make checks payable to Polytechnic School)



I / We plan to make a gift of appreciated securities.

Pledge Amount $_________________ to be paid in one two three installments Date(s)_______________________ Amount(s) $______________

Gift preference (optional):

f: _______________________________________

opt out of recognition events to receive the full charitable value of my gift. Instead of giving to the Poly Fund, I / we would like to designate our gift to the following fund: __________________________________________________________________ Matching Gifts Corporate matching gifts apply toward club levels. I will send my company’s matching gift form. Company:_____________________________

Amount $_______________

Planned Giving Opportunities I have made a provision for Poly in my estate plan. Please send me information on charitable trusts, gift annuities, and bequests. Contact Information

Name(s): __________________________________________________________ Street: ____________________________________________________________ City, State, Zip Code:__________________________________________________ Phone: ____________________________________________________________ E-mail: ___________________________________________________________ Class note for publication in the OakTree Times: ________________________________

_________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ You may also email your class note to [email protected].

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