Request Information

To request information from the Fund, please print and fill out this page.

Information desired:
___ How to receive assistance or services
___ How to apply for a scholarship
___ How to help the Fund with its events
___ Where are raffle tickets sold
___ Other (please specify) __________________________________

Contact information:
Name ________________________________________________

Address __________________________________________

Town _______________________________ State ______ ZIP _____

Telephone ______________________

E-mail _____________________________________

Mail this page to:
The Helpers Fund
6318 B Main Street
P.O. Box 691
Chestertown, NY 12817

The Helpers Fund is a 501(c)3 charity certified by the Internal Revenue Service 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.