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Please print
this page, fill it out and enclose it with your donation
In the tradition of Baruch, I entrust my gift, in
the amount of $_________, to Baruch Senior Ministries to further the
work of God's kingdom in caring for the elderly.
Donation Options:
Check (Payable to
Baruch SLS)
MasterCard
Visa
(Please check one)
Card#_________________________________________/exp. date________
Name:_________________________________________________________
Address:_______________________________________________________
City/State/Zip:___________________________________________________
Telephone:
(____)________________________________________________
Signature:______________________________________________________
Please use this
gift:
Fountain View
Assisted Living Center Cedar
Cove Where most needed
Please present this
gift: (optional)
In memory of
_________________________________________________
In honor of
___________________________________________________
Occasion_______________________________________________________
Please send an
acknowledgement to: (optional)
Name:_________________________________________________________
Address:_______________________________________________________
City/State/Zip:___________________________________________________
Mail this form with
your gift to:
Baruch Senior
Ministries:
3075 Orchard Vista Dr. Ste. 200, Grand Rapids, Michigan 49546
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