Donate by Mail or Phone
I am making a gift of: $25, $50, $100, or Other $___
Please use it for _________________________, or where most needed.
Your Name: ________________________________________
Your Company/Organization: _______________________________
Street Address: _______________________________________
City/State/Zip: _______________________________________
Phone Number: _______________________________________
Email Address: _______________________________________
Check or Credit Card Information
If you wish to use a credit card please complete the information below.Name on Card: _____________________________________________
Card Type: _______________________________________
Account Number: _____________________________________________
Expiration Date: _____________________________________________
and
Mail to:
Autumnwood Care Center
Donations Department
670 East State Route 18
Tiffin, OH 44883
To Donate by Phone:
Call (800) 899-0089 with your credit card information.
Please make checks payable to Autumnwood Care Center.
Please check that your name and address are correct to ensure proper
preparation for your tax receipts.
