Donations Form – Fighting For Children, Inc.

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

Ο $50 Ο $250 Ο $1000 Ο $2000 Ο $5000

Ο $100 Ο $500 Ο $1500 Ο $2500 Ο $10,000

ΟOther $__________________ (enter amount)Â

First name: ____________________________________________________

Last name: ____________________________________________________

Company/Organization: __________________________________________

Address 1: ____________________________________________________

Address 2: _____________________________________________________

City: _____________________________ State: ________

Zip/Postal Code: _______________ Country: _________________________

Phone: _____________________________

Email: _______________________________________________________

Credit card type: Ο Visa Ο MasterCard Ο Discover Ο 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.