Your donation funds:  All of our services are provided free of charge. You may choose to put your donation toward: (please check a box if you have a preference)

□ _________________________________________________
□ _________________________________________________
□  _________________________________________________
□ Other interests you might have ______________________________________

Your Name: __________________________________________ Phone: (____) ____________________

Address: ________________________________ City: ____________________ St: ____ Zip: _________

Email Address: ________________________________________________________________________

I wish to donate:

□ $5,000 or more $________ □ $1,000 □ $500 □ $250 □ $100 □ $50 □ other $_____
□ I am enclosing a check made out to Central Coast Funds for Children
□ please charge my Credit or Debit Card □ Visa or □ MasterCard

Card # _____________________________________ Exp. Date _________ 3 Digit security code ______

Billing address if different: _________________________________City: _________ St: ___ Zip: _____

Signature authorizing charge: ________________________________________

The donation is made In Memory of: _______________________ In Honor of: _____________________

Send Acknowledgement to: _________________________________

Address: _________________________ City: ____________________ St: _____ Zip: _______

Your gift is tax deductible and greatly appreciated. Please consider including Central Coast Funds for Children in your Estate Planning or Will.

□ I have provided for Central Coast Funds for Children in my Will or Estate Plan
□ I would like more information about the benefits of Planned Giving