Collinsville FFA Alumni
2400 W. Broadway, Collinsville, OK 74021 - 918-629-0632
collinsvilleFFAalumni@yahoo.com
Collinsville FFA Achievement Scholarships Donation Form
Name: __________________________________________________________________________________________
Company Name: ______________________________________________________________________________
Address: _______________________________________________________________________________________
City: _________________________________________ State: _________ Zip: _____________________________
Email: ________________________________________________________ Phone: ________________________
Please make checks payable to Collinsville FFA Alumni
 Please accept my tax-deductible donation of:
$10 ________
$25_______
$50________
$100________
Other: ________
Matching Company: __________
Include my donation with the following Scholarship(s):
(check all that apply)
_______Holman Scholarship
_______Collinsville FFA Charter Chapter #1
_______I would like to start a new Scholarship _____________________________________________
Please return this form and payment no later than March 1.
Collinsville FFA Alumni 2400 W. Broadway, Collinsville, OK 74021
Contact: Gina Quinn
Email: ginaquinn@me.com
Collinsville FFA Alumni is a 501c(3) non-profit organization. Our Tax Identification number is 54-0524844