Yes, I want to help Westminster Cares!

Please complete this form, print it and mail it to the address at the bottom of the form.

Name: 

Address:  

                 ,     

Email Address:  

Phone:  

Best time to Call:  

Contribution:   $                Call me about volunteering
          Payment Enclosed
          Call me

 Please print the form and mail it to:    Westminster Cares, Inc.
                                                                PO Box 312
                                                                Westminster, VT  05158

                                                                Thank You!