Gifts to Wheels for Kids, Inc.
(To print this form, only, click on the text and then use your normal print options)

Please print and use this form for contributions, memorial gifts, or for honoring you friends and family on special occasions. A beautiful card will be sent to them in your name.

Once completed, mail this form and gift to:
Wheels for Kids, Inc.
P.O. Box 57
West Palm Beach, FL 33402-0057

Please accept my tax deductible contribution of $___________
___ Check Enclosed (Please make payable to Wheels for Kids, Inc. )
___ VISA ___ MC  ___ AMEX

Name as it appears on card: __________________________________

Card#: __________________________  Exp. Date: ___________ Security code: _________

Street: ________________________   Zip: ___________
 
All contributions are tax-deductible as allowed by law.
Your Name: ___________________________________________________________
Address: _____________________________________________________________
City: ____________________________ State __________ Zip __________
E-mail Address: _____________________________________________ (To be held in privacy)
My gift is made:
In Memory of: _________________________________________________________
In Honor of: _________________________ for the occasion of ________
__________________________________________________________

Please Notify :

Name _____________________________________________
Address ___________________________________________
City_____________________________State____________Zip__________
...We thank you for your generosity...
WHEELS FOR KIDS, INC.
A 501(C)3 ORGANIZATION
EIN: 20-0227249

A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED
FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE (800-435-7352) WITHIN
THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR
RECOMMENDATION BY THE STATE.