Taxpayers Name:______________________________
Social Security No._____________________________
(This information is for I.R.S. reporting only, and will be kept confidential)
Street Address:________________ City:___________, AZ Zip_______
Midtown Primary School (07-89-76-101 keep this number for your tax return)
*We Accept Cash, Check, Money Order, or Paypal.
Signature_____________________________
Apply this donation to: ______ General extra-curricular activities
______ Ms. Kristi's music program
Print out this form and mail in with your donation to: Midtown Primary School
4735 North 19th Avenue
Phoenix, AZ 85015
If you are donating through PayPal, please email this form to
midtownprimaryschool@hotmail.com
