Please print & use this page as your donation form.

Family and Children's Service of Midland
(989) 631-5390

DONATION FORM
I/We would like to provide the following donation to support Family and Children's Service of Midland's mission and efforts.
Please complete donor information as you wish it to appear in our records.

Name__________________________________________

Address________________________________________

City/State/Zip____________________________________

Donation Amount $_______________________________
Please make checks payable to Family and Children's Service of Midland

I prefer to donate by credit card

bd21504_.gif (182 bytes) VISA   bd21504_.gif (182 bytes) Master Card   #___________________________

Expiration Date_________________________________

Signature______________________________________

Please direct my donation to:

bd21504_.gif (182 bytes) Area of greatest need
bd21504_.gif (182 bytes) Treatment Services
bd21504_.gif (182 bytes) Community prevention services
bd21504_.gif (182 bytes) Other:

bd21504_.gif (182 bytes) Contact me/us to discuss other ways we can help

Address:

Phone:
Please send an acknowledgment:

In honor of_____________________________

In memory of___________________________

Address_______________________________

 

Mail your Donation to:
Family and Children's Service of Midland  1714 Eastman Ave.  Midland, MI 48640

Thank you for investing in Family and Children's Services of Midland's mission.
As FCS Midland is a 501(c)(3) charitable organization, your donation is tax deductible as allowed by law.

     


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