Hilltop High School DOLLARS for SCHOLARS (TM)(R) RESPONSE FORM

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Name:

email address:

Street Address:

City, State, Country, ZIP:

Phone Number: (W)

Phone Number: (H):

Check all that apply:

Send me more information via e-mail.

Send me an email reminder about next meeting.

I am interested in volunteering.

I want to donate.

How to reflect my donation: (examples: John Jones, John and Jane Jones, Mr. & Mrs. John Jones, etc

Anonymous

In Memory of / In Honor of:

My Graduating Class Year:

None HHS Parent HHS Student HHS Teacher or Staff Other

HHS Affiliation, if any:

Comments:

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