This form is for donating to St. Anthony’s Padua Dining Room by cash or check.
It also provides for donating in memory or honor of someone.
Please print the form, complete, enclose it with your donation and mail it to
St. Anthony’s Padua Dining Room
3500 Middlefield Road, Menlo Park, CA 94025-3099.
Please complete the information below and check boxes ( ) as needed:
First Name: ______________________ Last Name_____________________________
City: ___________________________________ State__________ Zip: ______________
Phone: _____________________E-mail: _______________________________________
( ) I would like to make a donation of: _________________________________________
( ) I would like to make a monthly pledge of: ____________________________________
( ) I would like this donation to be used for: ________________________________________________________________________
( ) I would like this donation to be in honor of: memory of: ________________________________________________________________________
Additional memory/Honor information if required: ________________________________________________________________________
( ) Please send card to: ( ) No card needed.
City: _________________________________ State__________ Zip: _______________
You and the individual(s) named above will receive separate acknowledgements.
Your dollar amount will not be indicated on their acknowledgement.
( ) $100 ( ) $250 ( ) $500 ( ) $1,000 ( ) $5,000 Other: _____________.
Gifts to St. Anthony’s Padua Dining Room are tax deductible as permitted by law.
Tax ID #94-3151091. If you need more information, please call
Max Torres, Operations Manager: (650) 365-9664