LovingNeighbors Donation:

 

NAME:_________________________________________

ADDRESS: _____________________________________

CITY, STATE, ZIP: _____________________________________

PHONE:  _______________________________________

QUANTITY     ITEM                                        TOTAL
_________     House Starter Kit @ $500        ________

 ________      Partial Kit @ $125                  ________

_________     General Donation                    ________   

 

PLEASE WRITE "LovingNeighbors" in the memo section of your check and include this form.
Thank You!