FORM FOR A PERMANENT DONOR FUND

You can become a Philanthropist
by establishing a "Permanent Donor Fund"
in The Knights Templar Eye Foundation, Inc.
1000 East State Parkway, Suite I
Schaumburg, IL 60173-4592
Phone (847) 490-3838
FAX (847) 490-3777
ktefofc@ix.netcom.com

The Knights Templar Eye Foundation, Inc. sponsored by The Grand Encampment of Knights Templar of the United States of America was created a tax-exempt charity under the provisions of the Internal Revenue Code, under the laws of the State of Maryland and as such, all contributions/donations are tax deductible.

Those donors making an initial donation of $10,000.00 will be presented a "Golden Chalice". Those who make an initial donation of $25,000.00 or more will be presented the "Sword of Merit".

Any Donor, who wishes to have their name listed as a Permanent Donor of the Knights Templar Eye Foundation, Inc. may donate the sum of $10,000.00 or more to the Knights Templar Eye Foundation, Inc. for the purpose of generating income for The Knights Templar Eye Foundation, Inc. Endowment Fund. The principal of this "Permanent Donor Fund" will remain permanent with income being used for the general purposes of The Knights Templar Eye Foundation, Inc.

When the initial donation of $10,000.00 is received a receipt will be issued stating how additional donations can be added to the fund as well as Bequests. Additional donations must be in increments of $1,000.00 or more. This receipt will immediately recognize the donor as a Philanthropist who will be recognized in perpetuity.

The Donor may be an organization, foundation, corporation or individual. The Name of the Fund designated by the Donor shall appear in the Annual Report of The Knights Templar Eye Foundation, Inc. The purpose of including the fund by name is to give permanent recognition to individuals who want to help those who need the Knights Templar Eye Foundation, Inc. and permanently honor the Donor as a member of the "Permanent Donor Fund".

The Fund shall be designated: __________________________________Fund.

To properly recognize the Donor and to provide a copy of the Annual Report each year, the following information is needed:

Name of Donor: ________________________Phone (_____)_____________

Address ____________________City _____________State____ Zip_______

Additional Information____________________________________________

__________________________________________________________________

If a Commandery is to receive credit for the donation,
insert the name, number and state where the Commandery is located: __________________________Commandery No._____ State_______.

Initial Donation Enclosed: $_________________.