Make a Donation!
Wisconsin Polka Boosters
501 - 3C Non Profit Organization
W153 N10035 Neptune Dr.
Germantown, WI. 53022-5237
DONATION TAX EXEMPT FORM
(CORPORATION OR PERSONAL)
Please Print
NAME:___________________________________________________________________
ADDRESS:_________________________________________________________________
CITY:____________________STATE:____________________ZIP:_____________________
PHONE:_________________________
DONATION AMOUNT: $____________
% of donation to Wisconsin Polka Boosters
Expenses:______________________________
To pay for polka bands at the annual polka fest.
% of donation to Wisconsin Polka Boosters Scholarship fund:________________________
Wisconsin Polka Boosters Federal Tax I.D. #39 - 1149593
* Note: If a corporation, you can send an advertising board 20" X 24" for a display at our annual polka festival for the year of your donation.
Keep a copy of your check and this form for your tax records.
PLEASE MAKE YOUR CHECK PAYABLE TO: WISCONSIN POLKA
BOOSTERS
MAIL THIS FORM AND YOUR CHECK TO: TOM
RADTKE
6328 W. CEDAR ST.
WAUWATOSA, WI. 53213
ANY QUESTIONS CALL: TOM RADTKE
(262) 784-4486
VERN BLANKENBURG
(262) 255-2191
Received by Polka Booster:_____________________Date:___________Treasurer:_____________________