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Please direct my contribution as indicated:

_____ General Fund; use wherever it is most needed	_____ Holiday Drive - Food
_____ Food Program	_____ Holiday Drive - Clothing
_____ Scholarship Fund	_____ Holiday Drive - Heating
_____ Chestertown/Helpers Fund Food Pantry	_____ Holiday Drive - Discretionary

Name _______________________________________________________________

Address _____________________________________________________________

City ___________________________ State __________ Zip ________

Phone# (____) _________________ E-mail _____________________________________

Amount of contribution $ __________ Paid by check ____ credit card ____ (please complete CC information below)

   MC/Visa: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __  

   Expiration date: mo___ /yr___    3-digit CVC/security code __ __ __

Signature: ________________________________________

Print, complete and mail this page to:
The Helpers Fund
6318 B Main Street
PO Box 691
Chestertown, NY 12817

Thank you for your support!

The Helpers Fund is a 501(c)3 charity certified by the Internal Revenue Service and and governed by the IRS Regulations governing charities. The Fund is incorporated under the laws of New York State's Department of State, and is registered with the New York State Bureau of Charities.

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