Please print out this page, fill it out and return it
with your donation to:

The Groton Dunstable Education Foundation
Attn: Teaching Stars Program
P.O. Box 322, Groton MA 01450

Please make your check payable to:
The Groton Dunstable Education Foundation
(No cash, please!)

_____ Donated by credit card on-line – form submitted for additional information only

Your Name: ______________________________________________________
Address: ________________________________________________________
________________________________________________________________
Telephone:  _______________________   Email: _________________________
Child's name (if desired):_ ____________________________________________
Teacher/Educator Name:  ___________________________________________
Position (teacher, coach, etc.):  ________________________________________
School: ______________________________    Grade: ____________________
Comments [optional]:   ______________________________________________
________________________________________________________________
________________________________________________________________

Amount of donation: $_______________
Do you wish this donation
to be anonymous?  ___ Yes   ___ No

(Contributions to the Groton Dunstable
Education Foundation are deductible to
the extent allowed by law.)