

DONATION FORM
-- PLEASE TYPE OR PRINT CLEARLY --
Name __________________________________________
Address ________________________________________
City ___________________________________________
State ______________ Zip ___________
Contribution Level - (check one)
[ ] $25 - $99 - Friend
[ ] $100 - $249 - Sponsor
[ ] $250 - $999 - Patron
[ ] $1,000 Plus - Benefactor
Make checks payable & mail to:
The Fort Meade Museum Historical Foundation
Box 864 (Lynn)
Fort Meade, MD 20755
For further information about making a contribution to the Museum:
e-mail: FGGMMuseumFound@aol.com
Telephone: 703-933-0596