Name: _______________________________

Address: _____________________________

____________________________________

____________________________________

E-mail: ______________________@______

Phone No. (____) ______- ___________

Donation: $_____________________

100% of funds donated are fully utilized by our Program

To support our Program please send your cheque made payable to Every Child Counts or Bahamas Missions of Florida for Every Child Counts and mail to

(*) Donations of $250.00 or more are US tax deductible so please make your cheque payable to P.E.R.C. (Preservation, Environment, Restoration, Community) with a note in the memo line: Donation for Every Child Counts.
Mail to: Joe Shrier, 19300 Story Road, Rocky River, Ohio 44116.