Donation Form

Yes I would like to donate the following amount $__________

Enclosed is my check made payable to the Christ Child Society

of Texas.

Please provide the following information:

Circle Your Preferred Title: Ms Mrs Mr Dr None other

First Name: _____________________________

Last Name:_____________________________

Mailing Address: ____________________________________

City____________________

State ___________

Zip Code __________

Email ________________________________________________

Daytime Phone: ___________

Evening Phone ____________

Please mail your check to the following address:

Christ Child Society of Texas, Capital Area Inc.

P.O. Box 5953

Round Rock, TX 78683

Attn: Treasurer

THANK YOU

Christ Child Society of Texas,

Capital Area