RESPITE VOLUNTEERS OF SHIAWASSEE

www.shiarespite.org 

If you would like to offer your support to families
caring for someone with an ongoing illness . . .

Just print the form below.
Fill in and detach the lower portion.
Then, mail it to us with your donation check
(made payable to: Respite Volunteers of Shiawassee).

Keep the upper portion for your records.

Respite Volunteers of Shiawassee Thanks You!


Donation amt. __________    Check # __________    Date ____________


_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _


 MEMBERSHIP


   NAME: ________________________________________    DATE: _________________

   ADDRESS: ______________________________________________________________

   CITY: __________________  STATE: ______  ZIP: ________  PHONE: ______________

___ Individual:
 $20.00
___ Patron:
 $100.00
___ Family:
 $25.00
___ Sponsor:
 $250.00 - $500.00
___ Donor: $50.00 ___ Founder: $500.00 or more

Contributions to Respite Volunteers of Shiawassee are tax deductible as provided by law.

Please mail your contributions to:
Respite Volunteers of Shiawassee
710 W. King St.
Owosso, MI 48867

Phone: (989) 725 - 1127