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Please mail this donation form and your gift to:

Children’s Cancer Association 433 NW 4th Avenue, Suite 100 Portland, OR 97209

$1,000 $750 $500 $250 $100 $50 Other $ I would like to make a recurring monthly gift of: $ I will submit a matching gift request to my employer:

Payment Method: Enclosed is my check payable to Children’s Cancer Association Please charge my credit card: Credit Card #


My Information: Title (Mr., Mrs., Dr., etc.) Name (Donor) Company Address City Phone

State Email Address


  Tribute Gifts I wish to make my gift: Name

in honor of:

in memory of: Occasion

Please send a notification card to: Title (Mr., Mrs., Dr., etc.) Name (Donor) Company Address City



eMail Address


Please sign the card from: I have included Children’s Cancer Association in my estate plans. I would consider doing so, please send me information.


Thank you!

Phone: (503) 244-3141

Fax: (503) 892-1922


df_Artists 4 Life

Artists 4 life donation form