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* Address 1:
Address 2:
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Gift Details
* Gift Amount: 
Excellence Fund  $ 
Gym & Performing Arts Center  $ 
Endowment  $ 
Other  $ 
Total Amount:  $ 
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*Payment Schedule:

All Excellence Fund gifts need to be paid by June 30 to count in this year's Excellence Fund
Employer Match:

Name of employer for matching gift.

Other Details
* Donor names to appear as:
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In Honor of/In Memory Of:
Countryside School K-8
4301 W. Kirby Ave. Champaign, IL 61822