Job Connection Inc. HomeDonation Form

1501 14th St. W. Suite 220 Billings, Montana   59102  (406) 245-6323 Fax:  (406) 245-6768
email: rita@jobconnection.org

Job Connection is funded by contract with government agencies.   However, we have client emergency needs that are not covered by other funding sources and your donations are appreciated.  You can call us to make a donation or complete  this form, print it and mail it with your check .  All contributions are 100% tax deductible to the extent allowed by law.

First Name:
Last Name:
Title:
Company:
Address:
Address (Line 2):
City:
State:     Zip Code:  
Home Phone:
Work Phone: EXT:
Fax:
EMail:
I would like this donation to be used for: Client medical needs
Client emergency needs
Individual Sponsorship
General Support

Amount of Donation:     

Your Signature _______________________________Date ________