COUPON

PLEASE ACCEPT MY CONTRIBUTION TO THE SODA SPRINGS EDUCATION FOUNDATION, 250 E. 2nd S. , SODA SPRINGS, ID 83276

     _____   $200 (Please enroll me in the Heritage Club)

             $100 Century Club

             $50

             $20

             Other

FUNDS TO BE ALLOCATED AS FOLLOWS:

     ¨ Club/Organization (please specify):_____________________

     ¨ Teacher’s Classroom (please specify):____________________ 

     ¨ Sport (please specify):_____________________

     ¨ Foundation Discretion

Name                                                     

Address                                                  

Phone                                 Zip