Please consider a donation to The MSU Student Food Bank and \ or The Greater Lansing Food Bank

Your First and Last Name:


Your Address:

Street number, City

Your Phone Number:

555-555-1212

Your email address to contact you after the ride:


Your Donation To The MSU Student Food Bank:

00

Your Donation To The Greater Lansing Food Bank:

00

Would you like to donate $1 or more for Scott's Meal / Bed / Shower?

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Please fill in all the information boxes or your donation will NOT go through.

All information will only be used to contact you after the ride. Donations can be pro-rated on a 1300 mile ride, a penny a mile =$13.00

Any donations for Scott Meal / Bed / Shower will be greatly appreciated but not necessary.