NCCS Donation Form

Donor Information: (The "*" indicates a required value)

Name: *

Address: *

City: *

State: *

Zip: *

Day Phone: *

Email Address * (for communication):

Donation Options:

I would like to make a tax-deductible gift of: *$25
$50
$100
$250
$500
Other If "Other" Please Indicate Amount $

Please apply my gift to the following: *
NCCS Unrestricted
Specific Program. Please select program(s) from the list below.
Pantry
Energy & Heat
LifeLink
Boys & Girls Club
Big Brothers Big Sisters
Camp Newaygo Unrestricted
Children's Christmas Programs
Other

If "Other" please specify a program to apply your gift to:

I understand my credit card may be matched by the Fremont Area Community Foundation and that matching funds help support NCCS general and operating expenses.

My gift is a tribute in:

Honor of:
Memory of:
Celebration of:

Please send notification of my tribute to:

Name:

Address:

City:

State:

Zip:

I wish to contribute my gift anonymously.

I give permission to publish my name in NCCS publications:

YesNo

Please send information on including NCCS or Camp Newaygo in my will.

Donation payment:

Payment Method: Check/Money Order Credit Card/PayPal