MRTA SCHOLARSHIP DONATION FORM

                                                       Please return with payment to:

MRTA Scholarship Fund                                        or                                         Youngstown State University Foundation
Debra Mettee                                                                                                        Mahoning Retired Teachers Scholarship
680 Presidential Dr.                                                                                              606 Wick Ave.
Boardman, OH 44512                                                                                            Youngstown, OH  44502

Name: ___________________________________________________________________     Amount of Donation:  _____________________

Address:  ________________________________________________________________     

City, State, Zip:  _________________________________________________________   




    
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _  _ _ _