NORTH RANCH ELEMENTARY SCHOOL
16406 N. 61st Place, Scottsdale, AZ 85254
Donor's name: ____________________________________________________
Donor's Address ____________________________________________________
Donor's Phone Number: ______________________________________________
Please apply my donation of $______________ (make checks payable to North Ranch Elementary School).
$400
married couples filing jointly
$200
married couples filing separately
$200
single individuals/head of household
Please take the time to consider
carefully when allocating your contributions below.
You are responsible for
making thoughtful choices when allocating your tax credit dollars.
For:
__________________________________________________
(Student's name)
Towards:
Participation fee: _________________________________
(Before/After school activities, i.e. Chorus, Homework Club, GenYes, Rise, Read
& Shine, etc.)
Field Trip:
__________________________________
(Grand Canyon)
Other:
__________________________________
(General Fees)
I understand that my Tax
credit donations are non-refundable and non-transferable.
________________________________________________________
Contributor Signature