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Yes! I want to donate to the Milford Police Benevolent Association! Please complete this form, print it out, and enclose it with your payment, payable to; Milford Police Benevolent Association. Mail to:Milford PBA
430 Boston Post Rd
Milford, CT 06460
Contact Information
Name:_____________________________________________________________________ Phone number:____________________________________________________________ E-mail address:____________________________________________________________
Address Information
City:_______________________________________________________________________ State: _____________________________________________________________________ ZIP Code:__________________________________________________________________
Donation Information
Amount of Donation:________________________________________________________ In Memory of:______________________________________________________________ In Honor of:________________________________________________________________
Please send an acknowledgement card toName:_____________________________________________________________________ Phone number:____________________________________________________________ E-mail address:____________________________________________________________
Acknowledgement Address Information
City:_______________________________________________________________________ State: _____________________________________________________________________ ZIP Code:__________________________________________________________________ This section for Milford PBA Use Only Date Received _________________________________________ Received By _________________________________________________________________________ Read at Meeting_______________________________________________________________________ Acknowledgement Card Sent_____________________________________________________________
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