"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 


  checkbox Donation in the amount of $ 


Corporate Affiliation

Mailing Address

City / State / Zip

Day Phone

  This gift is: checkbox from me, personally checkbox on behalf of my organization
  checkbox Bill me
  checkbox Check enclosed - make checks payable to Earline Parmon Scholarship Fund
  checkbox American Express   checkbox Visa   checkbox MasterCard   checkbox Discover   

Card Number / Card Expires (MM/YY) (Security Code)


Your Signature / Today's Date (MM/YY)
  checkbox 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



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