I am making a gift of: $5, $15, $25, $250 or Other $___

Please use it for  _________________________, or r where most needed.

Your Name: _______________________________________

Your Company/Organization: _______________________________________

Street Address: _______________________________________

City/State/Zip: _______________________________________

Phone Number: _______________________________________

Email Address: _______________________________________

Check or Credit Card Information

Name on Card: _____________________________________________

Card Type: _____________________________________________

Account Number: _____________________________________________

Expiration Date: _____________________________________________

and

Mail to:
Volunteers of America
2112 Walnut Street
Harrisburg, PA 17103
(Please include check or CC #)

Fax to:
Volunteers of America
Attn: Web Donations
717.236.6930 (Only fax credit card donations)