W.R.A.S.P

Wahconah Refurbishing Auditorium Seats Project

Every 50 years our seats need a lift!

Name of Donor

Address

City

State

Zip

Phone Number

Amount of Donation

Check #

Please fill out NAME AND/OR DONOR NAME not to exceed (24 characters, including spaces), AS YOU WANT IT TO APPEAR.

Please select one:

• “ Gift”
• “ Dedicated to”
• “ In Memory of”