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“Please indicate your gift choice and I will be happy to purchase it for you.”

 

Name & Last name:
Phone #:
Email Address:
Address
City, State, ZIp
Please indicate the General Items you want to Help with: Small Radio (25) $15
Tickle Me Elmo® (2) $45
CD player with radio (11) $30
“Sound Soother” (10) $40
Child-size Recliner (1) $100
DVD Player (6) $100
Therapeutic Puzzles (5) $30
Therapeutic Peg Boards (5) $40-75
Light & Sound Toys (5) $30-35
Radios with headphones (5) $20-45
Electric Shavers (10) $45-65
Art Supplies (5) $250
Camera (2) $250-350
Electric Tooth Brush (12) $80
Rocking Chair (3) $100-250
Coloring Books/Crayons (any) $5
Video/Computer Games (any) $25-50
Television (15) $400
Large Radio “Boom-box” (1) $100
Typewriter (1) $100
Stereo System (5) $100
Adult-size recliner (3) $300
Treadmill (1) $1000
Large Screen Television (2) $2000
Computers (any) $500
Swing Set (1) $400
Please indicate the Personal Items you want to Help with (you can choose more than one line): Make-up kits (4) $20
Jewelry Box (1) $35
Compact Discs (various) (any
Jewelry/Watches (male & female) any $25
Cologne (male & female) (any) $20
DVD Movies (various) (any) $20
Please indicate the Preschool Items you want to Help with (you can choose more than one line): Tricycles (6) $25-45
Riding Toys (6) $20-40
Pre-K computer programs (MacIntosh) $60
Professional Bubble Machine (1) $60-100
Laminating Machine (1) $1000
Sweat Suits(medium, large, x-large)$25-35
Computer printers (any) $100
Please select a form of Payment Credit Card
Check
Money order
If you Choose Credit Card Please choose Type Master Card
VISA
AMEX
Number
Exp Date:
Please Confirm the Amount of your Donation