:::Donate - The Earline Parmon Scholarship Fund:::

	"Whatever the need, whatever the impediment, we are committed to providing solutions through the Earline Parmon Scholarship Fund. Thank you for supporting this important program and making an investment in the future." ~Tanya R. Wiley - Executive Board Print out this form, complete the donation information, and mail to: Earline Parmon Scholarship Fund 3320 Robinhood Rd.,#101 Winston-Salem, NC 27106

	Donation in the amount of $

	Name
	Corporate Affiliation
	Mailing Address
	City / State / Zip
	Day Phone
	E-Mail
	This gift is: from me, personally on behalf of my organization

	Bill me
	Check enclosed - make checks payable to Earline Parmon Scholarship Fund
	American Express Visa MasterCard Discover
	Card Number / Card Expires (MM/YY) (Security Code)
	Your Signature / Today's Date (MM/YY)
	I'd like to eliminate tax gains by making a gift of stock. Please contact me concerning my gift.
	Thank you for your support. Checks should be made out to the Earline Parmon Scholarship Fund. You will receive a letter for your files confirming the gift. Copyright © 2016 The Earline Parmon Scholarship Fund All Rights Reserved