YES! I want to make a tax-deductible financial contribution to support a local Enterprise Facilitation program for the North Santiam area.

We are unable to accept on-line contributions at this time. Please print out this page, complete and return to the NSCEDC at the address below.

Please accept my contribution at the following support level:

________ $50,000 – Diamond

________ $25,000 – Platinum

________ $10,000 – Gold

________ $5,000 – Silver

________ $1,000 – Bronze

________ Contributor – Specify amount: $___________________

Your contribution is tax deductible for income tax purposes. Once your contribution is received, a receipt acknowledging your contribution will be provided.

Thank-you for your generous support of the GROW North Santiam Program!

Contributor Name:  _________________________________________________________________

Contact Person (if different from above): ____________________________________________

Telephone: _____________________________ 

E-mail: ___________________________________

Mailing Address: ____________________________________________________________________

____________________________________________________________________

_________________

Authorized Signature: 

_______________________________________________________________

Please make checks payable to:

North Santiam Canyon Economic Development Corporation

P.O. Box 673

Mill City, OR 97360

Tax ID# 93-1221875