Donation Form





I would like to make a gift of $_________ to Learning Disabilities of CNY.


Name_________________________________________________

Adress_______________________________________________________________________

City_____________________________________________State__________Zip__________

Day Phone_____________________________________________


Enclosed is my check for $________________(Payable to LDACNY) 

or please charge $___________________(please check one)

____Visa  ____Mastercard (For $30.00 or more only)

Please send receipt  YES_____  NO_____

Mail form to:
Learning Disabilities Association
722 West Manlius Street
E.Syracuse, NY 13057

To fax a donation using Visa or Mastercard, 
the fax number is (315) 431-0606




I would like more information about:

___Naming Learning Disabilities of CNY in my will

___Making a contribution that will provide income during my lifetime

___Making a contribution through the purchase or transfer of a life insurance
   policy.

___Making a contribution through the sale of stock.


For more information please call (315) 432-0665
or email us at LDACNY@LDACNY.org