This document is a contribution form for the Lanford Family Highway Worker Memorial Scholarship. It lists various contribution levels from $250 to $10,000 and provides fields to enter contact and payment information. Payment can be made via check made out to ARTBA-TDF or by credit card, with the form requesting the card number, expiration date, name on card and signature. It notes that contributions may be tax deductible and instructs the contributor to consult their attorney or tax advisor regarding deductions.