Children's Home Society of Washington



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Contribution Form


To donate by mail to Children's Home Society of Washington,
please print, fill out and mail this form to:

Development Office
Children's Home Society of Washington
P.O. Box 15190
Seattle, WA 98115


I want to support Children's Home Society of Washington to ensure a brighter future for children. Enclosed, please find my check made payable to CHSW in the amount of (please fill in appropriate line):

$1,000 + Second Century Club $ __________
$500 - $999 Ambassador $ __________
$250 - $499 Guardian $ __________
$100 - $249 Investor $ __________
up to $99 Supporter $ __________

Name _________________________________________________

Address _______________________________________________

City ______________________ State ___________ ZIP _________

Day Phone __________________ Evening Phone ______________

Email _________________________________________________
I may be contacted by email.
Please do not contact me by email.

Please accept my gift in recognition of the following:
Memorial   Anniversary   Birthday Holiday   Other

Person Honored _________________________________________

Please send an acknowledgment card to:

Name _________________________________________________

Address _________________________________________

City ___________________ State _________ ZIP ___________

I am interested in becoming a regular (monthly/quarterly) contributor. My employer will match my gift, enclosed is my matching gift form.
I have remembered CHSW in my will.
I am interested in information on the advantages of planned giving.
Please do not include my name on published donor lists.