YES,
I will help The Center of Concern help others with my gift!

Enclosed is my contribution of $1,000, $500, $100, $50, $ ____________

Please charge my contribution of $________   to   Visa   MasterCard

# _________________________________________ Expiration date ____________


Signature ____________________________________________________________

This gift is   in memory of   in honor of   in celebration of

_______________________________________________________________________

Please send acknowledgement of this gift to ______________________________________

___________________________________________________________________________

Address ________________________________________________________________


My Name _______________________________________ Phone _________________

Address _________________________ City/State __________________ Zip _________

All contributions are tax-deductible.
Personal information will be kept confidential.
Please remember The Center of Concern in your will.


Mail to: The Center of Concern
1580 N. Northwest Hwy.   Suite 310
Park Ridge, IL 60068