First Universalist Church of West Chesterfield
10 Main Street
West Chesterfield, NH 03466
(603) 256-3293 ~ www.chesterfielduu.org
Donation Form
Please complete this form by printing legibly and returning it with your donation to
P.O. Box 10, West Chesterfield, NH 03466. Checks may be made out to “First Universalist Church of West Chesterfield”.
Name of Doner :_________________________________________________________
Address:_____________________________________________________________________ Phone Number:_____________________________________________
I Would like my donation to be earmarked for:
General Operating Costs
Facility improvement
Service providers (pastors and musicians)
Other ____________________________________
Total Donation amount $ __________