Donation Form

Yes! I would like to donate to The Katelyn Foundation!

Name (first and last): _________________________________________________________

Address: __________________________________________________________________

City, State, ZIP Code: ________________________________________________________

Phone number: ________________  E-mail address: _______________________________

I would like to support The Katelyn Foundation with a contribution in the amount checked below.

___ $25
___ $50
___ $100
___ $250
___ $500
___ $1000
___ Other $_____________

Please print this page, complete the form and enclose it with your payment, payable to “The Katelyn Foundation, Inc.”
Mail to:
The Katelyn Foundation, Inc.
c/o Robert J. Testo, III
50 Cherry Street, Suite F
Milford, CT 06460

Is your donation being made in memory or in honor of someone special? If so, please complete the following:

___ In Memory of: ________________________________________________________

___ In Honor of: __________________________________________________________

Memory Album: If you would like us to add a picture of your loved one for who's memory you are making a donation, please send it to the address above or email it. We'd be happy to add it to our Memory Album.

Thank you!