Please fill out and print from your browser

Appalachian Community Development Association Donation Form

Yes! I want to help support the Appalachian Festival and the Appalachian Community
Development Association's Small Grants Program.

Appalachian Festival Friends    
  $30 Contribution to the Appalachian Festival.
  $50 Contribution to the Appalachian Festival which includesFour (4) Complimentary General Admission tickets
Appalachian Festival Patrons    
  $100 Contribution to the Appalachian Festival which includes Eight (8) Complimentary General Admission tickets
Name
Address #1
Address #2
City
State
Phone
Email
My Check/Money Order is Enclosed in the amount of:
Please Charge my Contribution to my Credit Card. (Please Indicate MasterCard or Visa)

 
Signature (Required) _________________________________________________

Please mail Contributions to:
Allison M. Raisor

The Appalachian Community Development Association
PO Box 141099
Cincinnati, OH 45250

LOCAL 1.513.251.3378  |  FAX 1.513.251.3377