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Please allocate my gift for one of the following: Where it is most needed Bright Horizons Healthy Aging Senior Dining Transportation Umbrella of Colonie

Please accept my gift of: $50.00 $75.00 $100.00 $250.00 $500.00 $1000.00 Other

Other Amount:

I work / worked for a company who will match my gift:

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Please send a gift acknowledgement card to:

First Name	Last Name
Address	Address 2
City	State select Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip

Please recognize my gift of $100 or more with a Path Paver, an inscribed brick on the terrace of the Center.

Path Paver inscription of three lines (16 letters & spaces maximum per line):

If you wish to make a donation by check or credit card please print out Printable Version; Mail completed form along with payment to: Colonie Senior Service Centers, Inc. Six Winners Circle Colonie, NY 12205 Thank You! All donations are tax deductible to the extent of the law. CSSC, Inc. is a 501(c)3 not-for-profit corporation established in 1981. For further information call the Development Office at (518) 459-2857, ext. 304.