Enclosed is my general contribution in the amount of:  $____________________

Please make checks payable to (do not send cash): 

Parkinson's Unity Walk, P.O. Box 275, Kingston, NJ 08528  Toll free:  1-866-PUW-WALK (789-9255)  Fax:  609-688-0875  E-mail: info@unitywalk.org Web site: www.unitywalk.org

YOUR NAME______________________________________________________________________

ADDRESS_________________________________________________________________________

CITY________________________________STATE______________________ZIP______________

TEL________________________________________FAX___________________________________

E-MAIL____________________________________________________________________________ 

---

This is a gift in Loving Memory Of:  _______________________________________________

This is a gift in Honor of:  _______________________________________________________

 

Please send an acknowledgement card of my donation to (Honoree or Family of deceased):

NAME______________________________________________________________________________

ADDRESS___________________________________________________________________________

CITY__________________________________STATE__________________ZIP__________________

Parkinson's Unity Walk is a 501 (c)(3) non-profit organization.  Contributions are tax-deductible.