*Required Fields 
*First Name  
*Last Name  
Address 2
*Email Address
*Phone Number  

Please allocate my gift for one of the following:
Please accept my gift of:
Other Amount:
I work / worked for a company who will match my gift:
I would like to make this gift in Memory of:
I would like to make this gift in honor of:

Please send a gift acknowledgement card to:

First Name
Last Name
Address 2

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.