Harvest Dinner Donations Thank You For Supporting Our Programs! First and Last Name* First Last Home PhoneCell PhoneEmail* Address* Street Address Address Line 2 City State ZIP / Postal Code Ways to supportTitle 1 Schools Education InitiativesThree third-grade classes' Adaptations program at the farm ($720)Three classes' in-school program ($400)One class fieldtrip at the farm ($240)One in-school program ($150)Residential Summer CampOne child's ten-day camp experience ($1,600)Food & supplies for one ten-day session ($1,500)Cost of the swimming pool for one session ($200)NPF tee-shirts for one session of campers ($150)Swim goggles for one session ($95)Payment OptionsPayment Method*Credit Card / PaypalCheck (Drop off or mail)Corporate Matching Please check if you are employed by a company which matches charitable gifts. Total $0.00 Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Expiration Date Security Code Cardholder Name Comments