2016 Contribution Form

General Federation of Women's Clubs of Massachusetts Elfriede Parker, President

Club ______Person Completing Form ______Email ______Phone______Club Contribution Deadline is January 30, 2017 to be credited to the 2016 fiscal year Send one check for the total donations recorded on these two pages payable to: GFWC of Massachusetts P.O. Box 679, Sudbury MA 01776-0679 ______

GFWC of Massachusetts:

GFWC of MA Scholarships (funded only by club contributions)  “Pennies for Art” Scholarship $______ “Nickels for Notes” Scholarship $______ Communications Disorders/Speech Therapy $______ International Study Abroad Scholarship $______

GFWC of MA President’s Project - Autism The Boston Higashi School, Randolph $______

 MassSTAR – High School Leadership Conference $______(cost to sponsor one student is $175.00)  Endowment Fund $______ Headquarters Fund (Maintenance) $______ Headquarters Fund (Parking lot paving) $______ Memorial Forest Fund $______

SUB-TOTAL CONTRIBUTIONS $______GFWC Partnerships - National Emphasis Areas GFWC Domestic Violence Awareness and Prevention Program Success for Survivor’s Scholarships $______Prevent Child Abuse America $______Women’s History & Resource Center (WHRC) @ $______GFWC Headquarters, Washington D.C. March of Dimes - Advocates for Children $______St. Jude Children’s Research Hospitals - Advocates for Children $______Nature Generation - Conservation $______Hugh O'Brien Youth Leadership* - Education $______Canine Companions for Independence - Home Life $______Easter Seals - Home Life $______Heifer Project - International Outreach $______Operation Smile - International Outreach $______Shot @ Life (Immunization) - International Outreach $______UNICEF - International Outreach $______Sew Much Comfort - Public Issues $______USO (Active Military) - Public Issues $______

SUB-TOTAL CONTRIBUTIONS $______SUB-TOTAL CONTRIBUTIONS (page 1) $______

TOTAL CONTRIBUTIONS FOR 2016 (check amount) $______

* HOBY is the GFWC High School Leadership Conference partner. In Massachusetts we have supported the MassSTAR Youth Leadership Conference for over 12 years. Clubs may choose to donate to either or both or neither.

If you have any questions, please contact GFWC of MA Treasurer, T Jablanski: [email protected] 508.769.9008