Financial or In

Financial or In-Kind Donations
To make a financial or in-kind donation to LifeSpan, please call (513) 868-3210
or print and mail this form to the address listed below.
Yes, I want to help! Enclosed is my contribution of:

$50 $150 $250 $500 Other

Name:

Address:

City:

State:

Zip Code:

Day Phone:

My company participates in a matching gift program.
Enclosed is the matching gift form.

Check if you do not want to be listed in our annual report.

In memory / honor of:

on the occasion of:

Division for designation:

Clinical Counseling

Home Care

Guardianship

Credit Counseling

General Fund

Please Notify:

Name:

Address:

City:

State:

Zip Code:

Your gift to LifeSpan is tax deductible to the fullest extent of the law.

Please make checks payable to:

LifeSpan, Inc.

Thank You!

Clinical Counseling - Credit Counseling - Home Care/Guardianship - Home - Opportunities/Free Gifts

LifeSpan

1900 Fairgrove Avenue (Rt. 4)

Hamilton, Ohio 45011