Cochise Christian School Tuition Organization, Inc.

9991 S. Muffin Lane

Hereford, AZ 85615

(520) 378-3177 or (520) 417-2835

edwards27@cox.net or twa767capt@yahoo.com

Donation Form

Donor’s Name __________________________________________________________

Last Name First Name M.I.

_______________________________________________________________________

Mailing Address City State Zip Code

Telephone Number: (_______) _______________ E-mail address:________________

Amount of donation: $______________ Check No. ___________________

Christian School designated to receive your donation: ____________________________

Student recommended to receive your donation: ____________________________________

Information:

1. If the donor wishes to recommend a specific student or family to receive a tuition grant, enter the name in the space above. Actual tuition grants are subject to the discretion of CCSTO Selection Committee. The Arizona Statute prohibits any designation of your own dependent as a potential recipient.

2. Donations will be used for tuition grants/scholarships for K-12 students attending Christian schools in Arizona. Awards will be made without regard to the student’s race, color, sex, handicap, familial status, or national origin. One Hundred Percent (100%) of the donated funds received will be used for tuition grants/scholarships. Funds are distributed to schools as soon as possible following the grant/scholarship award.

3. The maximum Arizona State income tax credit is as stated in the latest edition of the Arizona Revised Statutes Section 43-1089. The total amount of your donation need not be sent to CCSTO at one time, but may be sent in installments if more convenient.

4. Donations must be postmarked or delivered to CCSTO by December 31 to be claimed as a credit for this year. Receipts will be mailed to donors by the following January 31.

5. Make checks payable to CCSTO (Cochise Christian School Tuition Organization Inc.) Mail check and completed Donation Form to CCSTO.