Commonwealth Education Organization

                                 Donation Form

When sending a donation, please print and complete this form.  

CEO thanks you for your contribution.

Name _____________________________________________

Address ___________________________________________

Phone ___________________   Fax   ____________________

Email ____________________

                                     Contribution

A gift of $__________

An annual pledge of $_____________ to be paid as follows:

              ____   one payment

              ____   quarterly payments

              ____   monthly payments

This pledge is for ____ one year    ____ two years    ____   three years

Signature: ____________________________________________

Comments:   __________________________________________

____________________________________________________

                                                                                                                                                                         Please mail this form and your check to:       

                     CEO

                     90 Beta Drive

                     Pittsburgh, PA 15238

CEO is a 501(c)(3) organization.  Cash contributions are tax deductible

as provided under the IRS Code.

Thank you for your support.