American Patriot Scholarship Program
I would like to support COL Brad Smith, USA as he hikes the Appalachian Trail to raise funds for the American Patriot Scholarship Program. 
I would like to contribute $    per mile (5 cents equates to Approx. $120) 
or with a gift of:   or  $ 
Name: 
Address: 
City : 
State: 
Zipcode: 
Email: 
Chapter: 
Print this page and mail along with your check made payable to the
American Patriot Scholarship Program
Enclosed is  $
Return this form with your pledge amount or check to the
MOAA Scholarship Fund
Dept. 889
Alexandria, VA 22334-0889

Or call 800-234-6622.


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