Help others by
giving to Winchester Utilities Project Help Program
Yes, I would
like to help those in need of help, such as the elderly and disabled, with
their utility bill. Please add $1 (or more in an even dollar amount: $_______)
to my utility bill until further notice. I understand my contribution to
Project Help is tax deductible. If you are already giving, you do not need to
complete this form again.
100% of all
donations collected will go into the Project Help program.
Name (as it appears on the utility bill)
_________________________________________________
Address
_________________________________________________________________________
Account Number ___ ___
___ - ___
___ ___ ___
- ___
Signature
___________________________________________
Date _____________________
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Please print this form and send it to