Child Name _____________________________________________________ School _________________________________________________________ Grade _________________________________________________________ $5 Requested Donation ___________________________________________ (checks can be made payable to Huntington SEPTA)

SEPTA member? ________________________________________________

Please complete the above form and return in your child’s backpack to school in an envelope marked SEPTA Bike Clinic. Donation checks can be made out to Huntington SEPTA

This program is made possible with the generous support of Kids Plus Inc.

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Page 1. Child Name. School. Grade. $5 Requested Donation. (checks can be made payable to Huntington SEPTA). SEPTA member? Please complete the ...
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