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direct impact gifts Make an immediate difference in the life of a child with your gift.
Print this form and fax it directly to Aviva at (323) 436.7042 OR mail it to: AFCS, 7120 Franklin Avenue, Los Angeles, CA 90046 Attn: Dir. of Development
For the holidays: $17.50 - Special holiday dinner for an abused child $30 - Holiday toy from a child's personal wish list
$25 - Day trip for a child to a local museum
$50 - Birthday party for an abused child
$100 - Eyeglasses for a troubled teen
$200 - Adopt a Foster Family
$350 - Birthday gifts for 10 children in Aviva's programs
$500 - A year of special education supplies/materials for 1 student
$1000 - 1 new computer for a classroom
Other
Name
Company Name
Address
City
State
Zip
Daytime Telephone #
Fax #
METHOD OF PAYMENT
Check
Credit Card Visa Mastercard
Card Number (no spaces or dashes)
Expiration Date (MMYY)monthyear:
Full Name as it appears on the card:
THIS DONATION IS
In Honor of
In Memory of
Please notify the following person of the donation:
City State Zip