To support the work of the Germans from Russia Cultural Preservation Foundation, I would like to make:

An unrestricted donation of:

_____ $1,000
_____ $2,500
_____ $5,000
_____ $7,500
_____ $10,000
_____ $Other

I prefer that my gift be applied to:

_____ Documentary production
_____ Humanitarian aid
_____ Educational aid
_____ Wherever it is most needed

Name ______________________________________________________

Address ____________________________________________________

City ______________ State/Province __________ Zip/Postal ___________

Country _______________________

Phone/Area Code ____________________ Fax _____________________

E-mail _________________________________

_____ For acknowledgement on the GRCPF web site, I would like my name to appear as shown.

_____ I prefer that my gift remain anonymous. Please do not acknowledge publicly.

I would like my gift to be _____ a memorial _____ in honor of

______________________________________________________________________.

Please notify the family of my gift by contacting:

Name ______________________________________________

Address ____________________________________________

City _________________ State/Province ________ Zip/Postal ______________

Country _______________________ E-mail ___________________________________________

I understand that my gift is tax-deductible to the full extent allowed by law. I further understand that my contribution may be used to match other gifts and grants including National Endowment for the Arts and National Endowment for the Humanities grants.

Mail to:
Germans from Russia Cultural Preservation Foundation
1301 8th Street South
Fargo, ND 58103-4223

Germans from Russia Cultural Preservation Foundation