Please print and mail this form along with your donation. Or you can donate on-line via PayPal
at www.Montlake.net
Enclosed is my gift of:
☐ $500
☐ $250
☐ $100
☐ $50
☐ $25
☐ $ ____________
Checks should be made payable to: Montlake Community Club
Thank you! Your gift is tax-deductible. Montlake Community Club is a registered 501(c)3
non-profit corp. If your employer provides matching funds, please be sure to enclose the
appropriate form.
Name (please print) __________________________________________________
Address ___________________________________________________________
City _ ________________________________State ___________ Zip __________
e-mail (optional—only if you would like to have the Montlake Flyer e-mailed to you and you
are not already a subscriber)
___________________________________________________________________
Please mail to:
Montlake Community Club
4616 25th Ave NE #446
Seattle, WA 98105–4183