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Family & Children Services' Donation Form

Thank you for supporting the work of Family & Children Services!

To make a cash gift to Family & Children Services, please print and complete the form below and mail it with your check or payment information to: Family & Children Services, Development Department, 375 Cambridge Avenue, Palo Alto, CA 94306.

You may also donate online or print a PDF version of the Donation Form.

I offer my support at the following level:

 Platinum Partners ___________________________________________$100,000 and above
 Gold Partners ______________________________________________ $50,000-$99,000
 Platinum Family Circle _______________________________________ $25,000–$49,990
 President's Circle____________________________________________$10,000–$24,999
 Family Circle_________________________________________________ $5,000–$9,999
 Benefactor___________________________________________________$2,500–$4,999
 Patron_______________________________________________________$1000–$2,499
 Supporter______________________________________________________ $500–$999
 Friend_________________________________________________________ $250–$499
 Associate______________________________________________________ $100–$249
 Other____________________________ (Gifts of all sizes help us serve more clients!)

Family & Children Services welcomes your contribution of stock, real estate, and other securities. Please call the Development Office at (650) 326-6576 for more information.

Name: ___________________________________ Phone: _____________________________

Address: _____________________________________________________________________

City, State, Zip:_________________________________________________________________

Email: ___________________________________ Today's date: _________________________

My check in the amount of $_______ payable to Family & Children Services is enclosed.

Please charge my credit card in the amount of $________ in one / monthly / quarterly payments for a total gift of $______.

Account #:_________________________________ Expiration Date: ___________

Name on card: _____________________________ Billing zip code: ____________

I would like my gift to remain anonymous.
I would like to receive information about bequests, making a gift to the Endowment Fund, or contributing real estate, stock, or securities.

Thank you for your generous support!

rev. 10/06