Click here to return to VITA’s Donation page.
Memorial Gifts to Literacy
Direction: Fill out the following form and mail it along
with your donation to the address below.
Once VITA receives your donation, we will send a card acknowledging your
memorial gift to whom you specify on this form.
VITA
Name
_______________________________________________
Address _____________________________________________
City, State, and Zip
____________________________________
Phone Number
_______________________________________
_____ Yes! I would like to make a Memorial Donation
to Literacy.
1. In memory of ________________________________________
Name
of Recipient
____________________________________________________
Name of Family
Member Address City,
State, Zip
2. In memory of
________________________________________
Name
of Recipient
____________________________________________________
Name of Family
Member Address City,
State, Zip
3. In memory of
________________________________________
Name
of Recipient
____________________________________________________
Name of Family
Member Address City,
State, Zip