Step 1: Please complete the following form.

Your Contact Information First Name: Last Name: Company: Phone: Email Address: Your Home Address Information Address: City: State: Zip: I would like to make a donation Donation Amount: Subtotal: My Company Has a Matching Program for Charitable Donations Total Donation: Do you want this donation to be a Memorial Donation? Yes No In Memory Of: Please acknowledge my donation to: Full Name: Street Address: Suite/Floor: City: State: Zip: Country: Email: Comments & Remarks: Do you want this donation to be a in Honor of Someone? Yes No In Honor Of: Please acknowledge my donation to: Full Name: Street Address: Suite/Floor: City: State: Zip: Country: Email: Comments & Remarks:

Step 2: Please write the check for the above amount to A Caring Hand.

Step 3: Please print this page and mail it, along with your check, to
            A Caring Hand
            c/o Powered By Professionals
            1375 Broadway, 3rd floor
            New York 10018