TCAA Contribution Form 

	I would like to contribute to the:

	___ Tiffin Columbian Alumni Association Scholarship Fund,   and/or the

	___ Tiffin Columbian Alumni Association Academic Enrichment Fund

	Enclosed is my gift of $___________ payable to the fund(s) checked above.

	This gift is in Honor of or Memory of

	_______________________________________________________________
                                                                                                                        

	Please send an acknowledgement of my tax exempt contribution to:

	My Name   ____________________________________________________

	My Address________________________________________________

                 __________________________________________________
 
	If this is an honorarium or memorial, please send an acknowledgement to: 

	Name	_________________________________________________________

	Address_____________________________________________________

		_______________________________________________________

	Print, Complete and Mail this form along with your check to:

	Tiffin Columbian Alumni Association
	300 S. Monroe St.
	Tiffin, Ohio 44883