The Salvation Army121 Cedar Street

Manchester, NH 03101603-627-7013

The Salvation Army

Back to School Program 2016

Please e-mail this form to info@SAmanchester.orgor fax it to 603-622-8332

We would like to donate:

$10 Wal-Mart gift card ____$20 Wal-Mart gift card ____

New backpack ____School supplies ____

Financial donation ____

Our organization would like to sponsor _____ children.

We can deliver the gifts.We would like the gifts picked up.

Coordinator: ________________________________________________________

Company: ________________________________________________________

Address: ________________________________________________________

E-mail: ________________________________________________________

Phone: ________________________________________________________

Please respond by July 27, 2016. Donations should be received by August 10, 2016.

Thank you for your generosity!