HELP US MAKE A DIFFERENCE GET INVOLVED

Choose a Program to Donate or Sponsor:

On Line Donation Amount

$25	$50	$75	$100	$250	$500
One time donation for the following amount:		$ (enter amount not listed above)

I would like to make a recurring contribution or donation

Gift Amount		# of Payments	Payment Frequency		Total Gift Amount
$	x		Monthly	=	$

Note: This transaction will count as the first payment toward your total gift amount __________________________________________________________________

Checks by Mail:
Should be sent to c/o Partnership For A Healthy Scott County, Inc., Post Office Box 329, Forest, MS 39074. (Phone Number (601) 469-5346)

Thank you for support and assistance