Grand Mound Rochester Park
PO Box 1266
Rochester, WA 98579
ROCHESTER PARK FUND
Sterling Savings Bank
Mailing Address ___________________________________________________
Phone ________________________ Email _______________________________
Amount Donated: __________________________________________________
Donations will benefit the development of the Rochester Community Park located at 10140 Hwy 12, Rochester – (playground of the former Rochester primary school).
Grand Mound Rochester Park Association is a nonprofit 501(c)3 organization. The purpose of the Association is to assist with the procurement and disbursement of funds and/or in-kind contributions for the development of and sustainability of parks and open spaces in the community. Donations may be tax deductible.
q Check if you do not want your name(s) included on membership lists or appearing in our printed materials. Your personal information will not be shared.
Signature(s) ________________________ Date _______________________
INSTRUCTIONS: Print this page and then take this completed form, along with your donation, to Sterling Savings Bank located 9921 Hwy 12 SW, Rochester WA 98579. You may also mail the completed form, along with your donation to Sterling Savings Bank, Attn: Karey Frafjord, PO Box 509, Rochester, WA 98579.
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