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Make A Donation

Yes, I want to ensure that older adults lead the stronger, healthier, more active and richer lives they desire and deserve.

If you would like to mail your donation, please print and mail the form below. Please make checks payable to "55 Kip Center". All gifts are tax-deductible.

If you would like to pay online, this form is secure and you can fill out the last section below and submit to have your donation processed.

$25     $50     $100     $250     $500     $

Name:

Address:

City: , State:   Zip:

Phone:   e-Mail:

My/My spouse's company has a matching gift plan. I have enclosed a matching gift form.
Please send me information on planned giving and bequests.

Stop here click the button below if you would like to print this form and mail in your donation. Continue on to the 2nd half of the form below if you would like to submit your donation online using our secure site.


Fill out this section if you would like to pay online. Please include billing name and address information if different from above:

Name as Shown on Card:
Billing Address:
Card Type:
Card Number:
Expiration Date:
          
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