Please use one of the forms below for donation or pledge

Please print this page, complete the appropriate form, and then mail to:

Open Fields School
37 Academy Road
Thetford, Vermont 05074

Checks should be made out to "Open Fields School - Trina Schart Hyman Memorial Endowment Fund". Contributions are fully tax-deductible to the extent provided by law. All contributions will be acknowledged promptly, and we will send all contributors a final report on the campaign.


Trina Schart Hyman Memorial Endowment Fund
OPEN FIELDS SCHOOL

Donor Information
Name(s): __________________________________________________________________
(If joint donation, enter both names here and provide two signatures below.)
Address: __________________________________________________________________
City: _________________________
State: _________________________
Zip Code: _________________________
Home phone: _________________________
Work phone: __________________________
E-mail address __________________________

I, We, _______________________ ("Donors"), individually/jointly, and severally make the enclosed contribution of $__________ to support the Trina Schart Hyman Memorial Endowment Fund at the Open Fields School in Thetford, VT.

___ I/We prefer that this gift remains anonymous.

___ I/We expect that this gift will be matched through the corporate matching program of ___________________.

Absent instruction otherwise, Donor(s) authorizes the Open Fields School to list his/her name in any of its publications or press releases.


Pledge of Donor Support

I, We, _______________________ ("Donors"), individually/jointly, and severally make the following commitment to support the Trina Schart Hyman Memorial Endowment Fund at the Open Fields School in Thetford, VT through a pledge of $__________. This pledge will be fulfilled as follows in the calendar years (ending December 31):

2007 $__________ 2008 $__________ 2009 $__________


______________________________ _________________________
Donor name Date
______________________________ _________________________
Donor name Date
______________________________ _________________________
Jean K. Aull, Director Date