Help Us, Donation form, Support The Center for Positive Connections (TCPC)

Thank you for your generosity. Please know that your gift will have a positive impact in keeping our valuable services available to the community.

With deepest appreciation,

James Konschnik
Executive Director
The Center for Positive Connections

YES! I want to support the work of The Center for Positive Connections.

Name:
Company Name (if applicable)
Address
City, State, Zip
E-mail
Phone

Enclosed, please find my tax deductible contribution of (please check/circle):

$50	$100	$250	$500
$1,000	$2,500	$5,000	$10,000

Other Amount: ________________

If by credit card please enter the following information:

Type Other
Credit Card Number:
Name as it appears on the card:
Billing Address
Billing City:	Billing State:	Billing Zip Code:
Signature:

If by check please make checks payable to: TCPC and mail to:

The Center for Positive Connections
12570 NE 7th Avenue, Suite 104.
North Miami, FL 33161

A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE WITHIN THE STATE 1-800-435-7352. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.