ALUMNI GARDEN CONTRIBUTION FORM

NAME________________________________________________________________

ADDRESS_____________________________________________________________

CITY___________________________STATE_____________ZIP_______________

AMOUNTS TO BE DONATED

$50 PLAQUE________________________   $500.00 6’ BENCH____________

 INFORMATION FOR PLAQUE OR BENCH

FULL NAME (UP TO 26 CHARACTERS)

FIRST, MAIDEN, LAST_______________________________________________

HOMETOWN_________________________________________________________

YEARS AT WNMU____________________________________________________

PLEASE MAKE CHECKS PAYABLE TO:

“ALUMNI GARDEN”  P.O. BOX 1158   SILVER CITY, NM  88062