IMAGE: Brinton Family Coat of Arms

Brinton Association of America

Donation Form
Name:
Address:
,     -
Phone: () - E-mail:

Specify Contributions:

 General Operating Budget: $

Director Fund: $

Endowment Fund: $

Genealogy/History Fund: $

Unrestricted (wherever needed most): $

TOTAL AMOUNT ENCLOSED: $
in memory of: 
as a tribute to: 

Payment: Check or VISA MasterCard Exp. Date /


Name on Card (print) 

Authorization (sign)   

Please advise me on how to:
include the Brinton Association of America in my estate planning.
donate art or artifacts to the archive collections.
All contributions are tax deductible.

Form instructions

  1. Print and fill out this Donation Form.
  2. Make a check payable to "Brinton Association of America, Inc." for the total sum of donations;
    or
    Provide the credit card information requested on the form, including card number and signature.
  3. Mail contribution and completed form to:

    		The Brinton Association of America;  Attn: Treasurer;
    21 Oakland Rd.; West Chester, PA 19382.
Official web site of the Brinton Association of America, Inc.
http://www.brintonfamily.org