Children's Tuition Fund Pennsylvania

← Children's Tuition Fund Pennsylvania Website

New One Time Donation

Donor Type

	Tax Filing Status
	Owner or member of an LLC, Sub S-Corp, Partnership or other Special Pass Through Entity
	C-Corp or Trust

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Business Name Organization Name

Contact Name

Is this organization a tax exempt 501c3?

EIN (Federal Tax ID Number)

First Name

Middle Initial

Last Name

SSN

+ Add Spouse Information

Address

Apt #

City

State

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Email Receipt To:

Contact Phone

This information will only be used to contact you with any questions related to your donation and will not be shared.

Please attach a copy of your State approval letter. Please fell free to black out amounts. NOTE: If you do not include your approval letter, it may significantly delay your contribution.

Select Program (one per contribution)

	EITC
	Pre-K
	OSTC

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Donor Commitment

Please indicate the status of this gift
	1st year of 2-year commitment
	2nd year of 2-year commitment

Payment Type

ALL checks MUST be mailed to the following address:

ACSI - CTF PA
PO Box 62249
Colorado Springs, CO 80962

Please confirm check date is for 2023 and made payable to Children's Tuition Fund Pennsylvania

Card Number

Expiry

PayPal payment processed

Account Type

Bank Name

Routing Number

Account Number

Description of Securities

Please complete this Security Transfer Form and forward it, along with the DTC Transfer Instructions found on the bottom of the form, to your Financial Advisor.

In addition, please forward a COPY of this form to deposits@acsi.org to ensure expedited processing of your transaction through the DTC wiring system.

Additional Notes or Comments? (optional)