Donation Form

 

 
 
Please print the form below and send it to:
 
Central Illinois Chapter of the Dream Factory
P.O. Box 1431
Pekin, IL 61554
 
Thank you for your support!
 
Name _____________________________________________
 
Address ___________________________________________
 
City, State, Zip _____________________________________
 
Donation Amount ___________________________________
 
Would you like a receipt _____________________________
 
In memory of ______________________________________
 
Any donations to The Dream Factory is tax deductible
 
Please make checks payable to
The Central Illinois Dream Factory

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