Donor Request Form

Donor Levels:

Friend

$5 - $249

Supporter

$250 - $499

Partner

$500 - $999

Advocate

$1,000

 Acknowledgement Information for the Website

(Please print Patron name(s) as you would like them to appear on the website)

For inclusion on the website, please fill this form along with the donation no later than July 28th, 2019.

Please make the check payable to:

Solace Haven, Inc.
P. O. Box 60574
Rochester, New York 14608

If you have questions, please contact: David Johnson @ 585-413-7188 or djohnson@solacehaven.org or Natasha Howard @ nhoward@solacehaven.org

With hard work and your help, we will have the resources to provide a positive, life altering change to the youth in our community. For more detailed information about how you can make an impact in the lives of so many who need it, please call us today 585-414-4725

You can also reach us by email through our website’s secure contact page. Thank you for considering this opportunity to partner with our organization.