PO BOX 2877
 TAMPA, FL 33601-2877
 TOLL-FREE 1-866-HK-CARES

  

CONTRIBUTION FORM
I, , wish to make a contribution to the Holland & Knight Charitable Foundation (the "Foundation")  in the following manner:

Check:  Enclosed is my contribution to the Foundation in the amount of $_________________________________.

Payroll Deduction (for Holland & Knight LLP employees only): 
I authorize the Foundation to deduct $_________ from each of my pay checks, commencing ________________, for a total yearly contribution of: $_____________.
 
 UNRESTRICTED CONTRIBUTION
 

 My contribution is an unrestricted gift to be used for the highest priorities of the Foundation.
 
______________________________

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Signature (for unrestricted contributions) Date
 REQUEST FOR DESIGNATED CONTRIBUTIONS

  My contribution shall be placed into a fund for the benefit of the following cause(s):
 
  1. Opening Doors for Children Fund.  Amount $__________________________.
    (Please state if there is a particular project or office program you wish to support)
     
  2. Holocaust Remembrance Project Fund.  Amount $_______________________.
    Note: All Holocaust Remembrance Project contributions will be used for scholarship awards, Holocaust Museum trips, and educational materials.
     
  3. Chesterfield Smith Ceremonial Classroom.  Amount $_____________________.
     
  4. New York Firefighter Memorial Wall.  Amount $__________________________.
     
  5. Other Holland & Knight Charitable Foundation project / program (please name):
     
  6. Other Charity.  Amount $__________________________________________. 
    Please indicate if you would like your contribution designated for another 501(c)(3) charitable organization.
     

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Signature (for designated contributions)

Date

Please make checks payable and submit to:  Holland & Knight Charitable Foundation, Inc., P.O. Box 2877, Tampa, FL 33601-2877        1-866-452-2737  (1-866-HK-CARES) (toll-free)
 

A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE WITHIN THE STATE OF FLORIDA (800) 435-7352.  THE TOLL OUT-OF-FLORIDA NUMBER IS  (850) 413-0840.  REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE OF FLORIDA.  REGISTRATION NUMBER SC-07612. 100% OF EACH CONTRIBUTION IS RECEIVED BY THE ORGANIZATION AND NONE IS RETAINED .