Exchange Club of Vicksburg Child Abuse Prevention Center, Inc.

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Donation Request Form

Please fill in the appropriate information and mail to the address below.

      Enclosed please find my tax deductible donation
      to assist the Center in providing services to families.
      I am interested in receiving more information about the Center.
      I am interested in becoming a volunteer and need more information
      about the opportunities available.
      Please add me to your mailing list.
      I am interested in a staff member speaking to my organization.

NAME:                                                                                           
ADDRESS:                                                                                     
                                                                                                       
PHONE:                                                                                         

For more information, contact:

Vicksburg Child Abuse Prevention Center
1529 Walnut Street Suite A
Vicksburg, MS 39180
601.634.0557
Fax 601.634.0093
e-mail: capctr@vicksburg.com