PLEASE SUPPORT OUR ANNUAL FUND DRIVE Your donations are needed to maintain our vital service to the Summit community. Any donation is appreciated!
$25 $50 $100 $250 Other:
Method of Payment: Check Enclosed VISA MasterCard American Express
Credit Card # Expiration Date:
Your Signature (for credit card): _____________________________________

Please complete the following in the event we need to contact you:

Name
Street address
City
State
Zip code
Home Phone
E-mail

Please make checks payable to: Summit Volunteer First Aid Squad.

Please print this completed form and mail to:

Summit Volunteer First Aid Squad
Fund Drive
P.O.Box 234
Summit, NJ 07902-0234

Thank You!