Scholarship Fund

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Scholarship Fund Donation
Help farmers attend the MOSES Conference

Conference Pricing:
Full Conference: $225
One-Day Conference: $130
Organic University Class: $180

$500
$230
$180
$135
$50
$

This donation is from:*

me personally my business

Notes

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First Name*

Last Name*

Farm / Business Name

Address, line 1*

Address, line 2

Email Address*

Phone

City*

Country

State*

Zip Code*

Payment Type:

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Bank Account*

Name on Account*

Bank Routing Number*

Bank Account Number*

Card Number*

Security Code*

Expiration Month*

Expiration Year*

Name on Card*

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ORGANIZATION NAME
ORG ADDRESS LINE 1 , Org City, ORG STATE ORG ZIP
ORG CONTACT PHONE | ORG CONTACT EMAIL

Thank you for your online donation to the MOSES Conference scholarship fund! A receipt will be emailed to you shortly.

Midwest Organic & Sustainable Education Service (MOSES)
PO BOX 339, Spring Valley, WI | 888-906-6737
info@mosesorganic.org | mosesorganic.org

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