Make all checks or money orders payable to:

American Cancer Society

Please printout this cancer donation form.
Send the completed form along with your donation to:

War On Cancer
P.O. Box 7172
Shawnee Mission, KS 66207

Date: __________________

My name:_______________________________________________________________

Address: _______________________________________________________________

City/State/ZIP: ___________________________________________________________

Amount of my donation: $__________

TYPE OF DONATION
(please check one):

In Remembrance of: ________________________________ __________________
(full name of person being remembered)
(your relationship)
In Support of: ______________________________________ _________________
(full name of person you support)(your relationship)
Caregiver: _________________________________________________________
(full name of caregiver being honored)(honored by name)
General donation



Thank you and remember, your donation is tax deductible.


www.waroncancer.us