Create a copy of this form with your browser's print function. Fill in the information and mail to:
Petaluma People Services Center
1500-A Petaluma Blvd South
Petaluma, CA 94952

Here is my tax-deductible donation in the amount of:

$25__  $50__  $100__  $__________

Does your employer match contributions?
Many will. Ask your personnel department.

Name :_________________________________________

Mailing Address (Street or PO Box):____________________________________

City: _________________________  State: __________  Zip Code: ___________

Email: _________________________