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Hadeland Lag Scholarship Donation Form

Make your check out to the Hadeland Lag and mail it with this form to:

Barb Schmitt

1006 Aston Circle

Burnsville  MN  55337



   Name __________________________________________________________________


   Mailing Address __________________________________________________________


   City  _________________________________________         State/Province __________


   Zip/Postal Code _________________       Country _______________________________


   E-mail ____________________________________________ 



Thank you for your tax deductible donation to the Scholarship Fund!
Amount Enclosed:  $     















The Hadeland Lag of America, Inc. is a non-profit organization incorporated in the State of Minnesota.  The IRS has

granted 501(c)3 tax exempt status.  Your donation to the Scholarship Fund is tax deductible, and

the Lag will send you a receipt for your tax records.