The following text can be printed out and mailed to (17 Kenmore Ave., Youngstown, OH 44507) for donations as well:

___Yes, I would like to donate to The Fish Samaritan House. Enclosed is my one-time donation of 

___$25    

___$50

___$100

___$500

___Other (please list amount)

 

__Yes, I would like to become a monthly partner with Fish Samaritan House. I would like to donate the following amount monthly. Below is my debit card information. Your contribution will be deducted from your account of choice, on the fifteenth of every month. This can be canceled at any time.

 ___$10   

___$25

___$100

___$500

___Other (please list amount)

 

Name, Address, Phone, E-mail, Card, Expiration, CVV

*Please note the address must match the address on your card.