Memorial Scholorship

 

 Plainedge Alumni Association Memorial Scholarship

Please cut and paste the form into your editor and return the  form with your check made payable to:

Plainedge Alumni Association

Mail to:

Plainedge Alumni Association, PO Box 1322, N. Massapequa, NY 11758

We thank you, in advance and with heartfelt gratitude, for your support in helping a PHS graduate achieve the goal of higher education.  

Plainedge Alumni Association Memorial Scholarship

 

Your Name:  ________________________________

Your Email Address: _________________________

Your year of graduation if Applicable ________

 

Amount of Donation:  $____________

 

If donating in memory of any alumni that have passed away, please fill in information below.

If more than one commemoration, please supply information for each alumni.

 

Name of Deceased Alumni: _____________________________

 

Class of (if known): ___________________

 

Date of Death (if known): ________________________     

For further information please contact:

Tony Sasso, President, Plainedge Alumni Association at TSasso@aol.com