Contribution Form

To make a donation to LocalHarvest, please print this form, complete it and send it to us with your check to the address below.

Yes!   I want to support LocalHarvest.

Name:_______________________________________
Street:_______________________________________
City:_______________ State:_____ Zip:____________
Email:______________________________
Home Phone: (   ) _________________ (Optional)

Enclosed please find my gift of:

___$25 ___$50 ___$75 ___$100 ___$500 ___Other $

Contributions to LocalHarvest are not tax-deductible.

Make your check payable to LocalHarvest and mail it with this form to:

LocalHarvest/Contributions
PO Box 1292
Santa Cruz, CA 95061
Thank you for your support!