Equipment Donation Form

I would like to purchase ____________________________________________________________

as a donation to the Sangamon Valley Youth Symphony.

Total donation enclosed $ ____________________

Name: ________________________________________________________

Address: ______________________________________________________

Telephone: _____________________________________________________

Please print this page and send it with your check (payable to Sangamon Valley Youth Symphony) to:

You will receive an ancknowledgment letter for tax purposes. Please contact SVYS before sending this donation to be sure the item is still on our "equipment needs" list. Thank you!