The Kent Center - Donation Form

The Kent Center for Human and Organizational Development

Your donation is greatly appreciated. If you would like to make a contribution by check, money order or credit card to The Kent Center, please complete the form below, then print this page and mail it to the address listed.

Please make your check payable to The Kent Center.

Arlene Stoltz, Director of Development
The Kent Center
2756 Post Road - Ste 104
Warwick, RI 02886-3003

Your Name

Address

City, State, Zip

Phone

E-Mail

Check enclosed in the amount of:

VISA/MasterCard

Card Number:

Expiration Date:

Verification Code:
(last 3-digits of code found of back of card)

Name on Card:

Signature:

I wish my gift to be given:

in memory to:
in honor of:

I wish my gift to be anonymous.

My gift will be matched by my employer.

I have enclosed my company's Matching Gift form.

Please contact my company for Matching Gift information.
My company's phone number is

Please send me information about including The Kent Center
in my will or estate plan.
I have already included The Kent Center in my will or estate plan.

Thank you for your generous support!

© Copyright The Kent Center (R) for Human & Organizational Development. All rights reserved.
The Kent Center Executive Offices • 2756 Post Road - Ste 104 • Warwick, RI 02886-3003
(401) 691-6000 • Emergency (401) 738-4300
Affiliated with Brown University School of Medicine and University of Rhode Island
Accredited by Commission on Accreditation of Rehabilitation Facilities (CARF)