(517) 265-5352 Phone (517) 263-6090 Fax
DONATION FORM
I/We would like to provide the following donation to support Family Counseling and Children's Services of Lenawee County's mission and efforts. Please complete donor information as you wish it to appear in our records.
Name__________________________________________
Address________________________________________
City/State/Zip____________________________________
Donation Amount $_______________________________
Please make checks payable to Family Counseling and Children's Services of Lenawee County
Please direct my donation to:
Area of greatest need Treatment
Services
Community prevention services
Other: Contact
me/us to discuss other ways we can helpAddress:
Phone:
Please send an acknowledgment:
In honor of_____________________________
In memory of___________________________
Address_______________________________
Family Counseling and Children's Services of Lenawee County
220 North Main Street
Adrian, MI 49221
Thank you for investing in Family Counseling and Children's Services of Lenawee County's mission.
As FCCServices is a 501(c)(3) charitable organization, your donation is tax deductible as allowed by law.