Small Comforts Ltd.

smallcomfortslogo.gif (3374 bytes)

smSmall Comforts Foundation
One Leslie Lane, Ithaca,
New York 14850
607-257-6059

I would like to pledge to the work of the Small Comforts Foundation Ltd. Enclosed is my tax deductible contribution in the amount of
$ ______________.

Deductions in any amount will be put to good use in one or more of the following services:

	Video Tapes for Patient Libraries
	Equipment Repair
	Equipment Replacement
	Program Expansion

Please note if you would like to allocate your donation to one or more of the above areas.

Donated in memory of ___________________________________

Name:______________________________________

Address: ____________________________________

City: _______________________________________

State: _____ Zip: __________

I would / would not like to be updated on the progress of Small Comforts via email at:
_____________@______________.________

Please print and mail this form with your donation.

Thank you for your donation.

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