2015 Summer Fan Drive

Make A Difference Today!

Donation Amount*
  • $30 - provides TWO fans**
  • $45 - provides THREE fans**
  • $75 - provides FIVE fans**
  • $150 - provides FIVE FAMILIES with fans**
  • $300 - provides 10 FAMILIES with fans**
  • Other $

**All donations to the Summer Fan Drive fund the purchase of fans and the continuum of services Family Eldercare provides to increase the safety, dignity and indpendence of the people we serve.

About You

First Name*
Last Name*
Company/Fan Drive Team Name
Country*
State / Province*
Address*
City*
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Email*
Confirm Email*
Phone*

Credit Card Info

Amount*
$
Name on Card*
Card Number*
Additional Comments

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