SCHOLARSHIP
DONATION FORM
NAME _____________________________________________
ADDRESS __________________________________________
CITY _________________________ STATE ____ ZIP ______
AMOUNT OF YOUR TAX DEDUCTIBLE DONATION $___________
If you have any questions about the scholarship fund, call (651) 379-1849,
email mnterritorialpioneers@yahoo.com or write to MTP at the address below.
Mail this form and your check to:
MINNESOTA TERRITORIAL PIONEERS
176 SNELLING AVENUE NORTH, SUITE 328
SAINT PAUL, MINNESOTA 55104-6338