Fighting For Children, Inc. Donation Form

Thank you for choosing to give to Fighting For Children, Inc.
Please complete this form and mail it with your check to:

Fighting For Children, Inc.

2685 Ulmerton Rd., Suite 210

Clearwater, FL 33762

You can also fax the form with your credit card information to: (727)573-6022.
We will process your donation and mail you an acknowledgement receipt for your tax records.

Gift Levels

      ❍ $50   ❍ $250  ❍ $1000 ❍ $2000  ❍ $5000

      ❍ $100  ❍ $500  ❍ $1,500 ❍ $2,500  ❍ $10,000

      ❍Other $__________________ (enter amount) 

First name: ____________________________________________________

Last name: ____________________________________________________

Company/Organization: __________________________________________

Address 1: ____________________________________________________

Address 2: _____________________________________________________

City: _____________________________ State: ________

Zip/Postal Code: _______________ Country: _________________________

Phone: _____________________________

Email: _______________________________________________________

Credit card type:  ❍ Visa  ❍ MasterCard  ❍ Discover  ❍ American Express

Account #: ___________________________________________________

Expiration Date: _______________________________________________

Cardholder Name: _____________________________________________

Signature: ___________________________________________________

Thank you

Your generous contribution enables our organization to become a voice for children
and further our programs designed to help children who are less fortunate and living in our community.