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To make a 100% tax deductible contribution to STOP! CHILDREN'S CANCER, Inc., simply complete and submit the form below.

Please note: STOP! CHILDREN'S CANCER does not share or supply personal information of our donors to anyone for any reason of solicitation or other purposes. For more details call us at 1-352-377-2622

Donator Info

Name:

Address:

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City:

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Contribution Type:

I would like to make an individual contribution to

Amount:

100

Other: (include dollar amount only - no $ sign ):

If you would like to make this gift in memory or honor of someone, please complete the following fields:

"In memory of"

"In honor of"

Name:

I would like to participate in the STOP! CHILDREN'S CANCER LEGACY FUND. Please bill me for the following amount:

10000

5000

2500

1000

Other::

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Words I wish to have on the permanent plaque (Platinum, Gold, Silver, and Bronze donors):

Send acknowledgement of this gift to:

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If you would like to mail or fax your donation, or contact us:

STOP! CHILDREN'S CANCER, INC.
2622 NW 43rd Street, Suite B3
Gainesville, FL 32606

Phone: 352-377-2622
Fax: 352-377-8972

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