GREATER ANDERSON PROMOTES PEACE

PEACE POLE PROJECT FOR BEECH ACRES PARK

GIFT FORM

Contributor Levels for 2005

_____ PAX CIRCLE $2500 AND UP

_____ SHANTI CIRCLE $1000 - $2499

_____ SHALOM CIRCLE $500 - $999

_____ PAZ CIRCLE $250 - $499

_____ PEACE CIRCLE $100 - $249

_____ FRIENDS All contributions under $100

Contact Name_______________ Organization__________________

Address_______________________ City______________ State___

Zip code__________________ Phone Number __________________

Fax ________________ E-mail ________________________________

For contributors at levels $50 - $999, please also complete the engraved paver form. Make checks payable to GAPP and mail to address above.

FOR SHANTI LEVEL -- Contributor name will be engraved at the site's dedication marker. Mark name on dotted line below or enclose disk, CD or attach letterhead/business card.

FOR PAX LEVEL -- Contributor name will be engraved at the site's dedication marker AND on Freedom Tree marker. Mark name on dotted line below or enclose disk, CD or attach letterhead/business card.

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Greater Anderson Promotes Peace is a nonprofit corporation and has status as a 501(c)(3) organization under the Internal Revenue Code. All contributions to the organization are tax-deductible to the extent permissible by law.

January 2005