By Making a Donation

Thank you for considering a gift to the Long Island Center For Independent Living. Your donation will be used to support the many services and programs that the Center provides to persons with disabilities.

Donations can be made in memory of loved ones who have passed away. LICIL also accepts monetary or real property contributions by way of charitable bequests and wills. Please consult with your attorney for possible tax benefits.

Your donation is tax deductible.

For your convenience you may either

fill out this form on-line and then print it, or you may print the form and hand write your information.

"The information you provide on this form is for LICIL’s use ONLY"

and will be kept confidential and NEVER be given to any other organization or person.

Yes, I wish to support the Center’s services and programs, enclosed is my gift of:

$25 $50 $100 $250 $500 $1,000 Other

NAME

ADDRESS

CITY STATE ZIP CODE

TELEPHONE E-MAIL

Please make checks payable to:

Long Island Center For Independent Living, Inc.

Mail your check & this form to:

Long Island Center For Independent Living, Inc.

3601 Hempstead Turnpike Suite 208

Levittown, NY 11756

Thank you for your generosity.

Print this page and mail with your gift.