Yes, I Want to Help My Local Planned Parenthood

This form cannot be electronically submitted. To support Planned Parenthood services in Broome, Chenango, Delaware and Otsego Counties, Please print this form and mail it to:

Planned Parenthood, 37 Dietz Street, Oneonta, NY 13820

Planned Parenthood, 117 Hawley Street, Binghamton, NY 13901

Your contribution is tax deductible to the extent allowed by law.

Name

Address

City

State

Zip

E-mail

Credit Card #

Card Type Card Expiration

Signature

    $250

    $100

    $50

    $25

    Other

    I would like you to send a card to someone in honor of my donation to Planned Parenthood of South Central New York, Inc. Please send the card to:

Name

Address

City

State

Zip

Or e-mail us your pledge at ppscny@ppfa.org. Call our Director of Development at 607-723-5130 ext. 216 for more information.

Donations to Planned Parenthood of South Central New York, Inc. support the local affiliate which serves women and men, teens and adults in Broome, Chenango, Delaware and Otsego Counties.

THANK YOU FOR YOUR SUPPORT!