Please PRINT this page and send all contributions and intentions to:

Oakwood Terrace
400 Gleason Road
Pittston, PA 18640

Ph:   (570) 451-3171
Fax: (570) 451-3172

Type of Contribution                                                   

• Monetary Donation
  I would like to contribute the following amount $______________.
  (Please include checks payable to: Oakwood Terrace)
  
  
  
• Outright Donation
  Please contact me as I would like to make a donation of the following:
  
  ____ Securities
  
  ____ Corporate Matching
  
  ____ Real Estate
  
  ____ In Memorial
  
  
  
• Planned or Deferred Gifts
  Please contact me as I would like to make a gift of the following:
  
  ____ Bequest by Will
  
  ____ Charitable Lead Trusts
  
  ____ Retirement Plan
  
  ____ Life Income Donation
  
  ____ Insurance
  
  
  

Name: ______________________________________________________________

Address: ____________________________________________________________

City: _______________________________ State: _________ Zip: ______________

Telephone: ______________________________ Fax: ________________________

E-mail address: _______________________________________________________