Donation Form

Thank you for your contribution to New Horizons.  Please complete this form and submit it electronically or print, complete and mail to:

New Horizons of the Treasure Coast, Inc., 4500 West Midway Road, Fort Pierce, FL 34981

 

Your contact information:

Name
Street Address
City State
Zip Code   Phone No.
E-mail

Please select your gift amount below:

$1000  $750  $500  $250  $100  $50  $25   Other  

Please select payment type:

Check                  Money Order             Credit Card         Card Type:  

Credit Card Information:

Credit Card Number: Exp. Date (mm/yy):

Credit Card billing name and address if different than above:          

Name
Street Address
City State
Zip Code   Phone No.
E-mail

Please direct gift toward:  Center for Children  Client Services  Special Events  Other (Enter below):

    

This gift is "In Memory of":                                        

      First Name
Last Name

Please send "In Memory of" acknowledgement to:

Name
Street Address
City State
Zip Code  

I am interested in receiving information on the following:

Naming Opportunities  Endowments  Planned Gifts  Gifts of Stock  Events

Comments:


For additional information on making a donation to New Horizons please contact:

Pat Daum

Director of Fund Development

(772) 468-4076

pdaum@nhtcinc.org

Nancy Swanson

Executive Administrative Assistant

(772) 468-4078

nswanson@nhtcinc.org
Copyright © 2007 New Horizons of the Treasure Coast, Inc.  All rights reserved.
Revised: 10/01/07