The Pietro Maugeri Foundation
"Have a good journey and be always happy - Sempre Allegro"
                         DONATIONS FORM
                   Please print form and mail to address below.

Name: __________________________________

Address:
________________________________

City:
_____________ State: ______ Zip: _______

Phone:
__________________________________

E-mail:
__________________________________

Amount: $ _______

Payment Options:    
    () Check
    () Money Order
    () Visa
    () Mastercard
    () American Express     

Credit Card #:
_____________________________
Credit Card Exp Date:
_______________________

Signature:
________________________________

Please Mail To:
The Pietro Maugeri Foundation
PO Box 93
Hillsdale, NJ 07642