One-Time Donation by Check

1. Please complete the following form:

* Indicates required questions

Please fill out the form below to notify us of the donation.

Name *


First	Last

Address *

City *

State *

Zip/Postal Code *

Phone # *

Email *

Amount you will be donating at this time: *

$25
$50
$100
$500
$1,000
$1,500
Other - Please specify:

Enter the check number so we can easily keep track of your payment: *

My gift is in dedication of someone special for:

If dedicating this gift, enter their name.
Include address if you would like an acknowledgment letter sent.

Enter code in image:

New Hope Center

315 Griswold St.

Northville, MI. 48167

New Hope Center, and include the reason for your payment on the memo line of your check.

One-Time Donation by Check