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Scholarship Donation Form

Name: ___________________________________ Grad Yr: ____________ School Graduated From:______________________

(Women include maiden name)

Occupation or Interests: _____________________________________

Spouse: __________________________________ Grad Yr: _____________School Graduated From:______________________

Present Address: ________________________________________________________

City: ______________________________ State: ___________ Zip: _______________

Here is my voluntary scholarship contribution of: $ ________

Support our youth now by printing this page and completing this form and mailing to:

Sue Crittenden Farschman
511 Riley Court
Lagrange, Oh. 44050

RETURN to Alumni home page

Last Construction Date: February 20, 2019
Edited by Jerry Long for LaGrange Keystone Alumni Association