Eppie Everywhere! 

The form below will give us the information needed to send you a receipt for your tax records.

Instructions:
1. Complete the form below.
2. Print a copy for yourself (and one to mail us along with your donation if you wish to donate using a check of money order)

Tell us how to get in touch with you:
Name:
E-mail: (This will be for our use only)
Phone:
Address:    Street
   City     
   State      Zip  

How many dolls would you like to purchase through this program?
          One for you and one to a needy child ($40.00)
          Two for you and two for needy children ($80.00)
          Three for you and three for needy children ($120.00)
          Cash donation (for every $15.00 collected a doll will be donated through this program)

Total Amount of Donation: $

Donation Method:

 Click the arrow to make your selection.  If you wish to donate using a credit card we will call you to get the appropriate information when this form is received, or you can call us at 770-479-9569

Enter any additional comments or questions: