Enclosed is my contribution check of $_____ to help the Greater Berks Food Bank provide food for malnourished children, adults and the elderly living in poverty. (OR)

Please bill my ____Visa,  ____MC,   _____AmEx
Acct: # _____________________________________________________ Exp. Date: _______

Signature: ___________________________________________________________________

Name: ______________________________________________________________________
Organization (if any): ___________________________________________________________
Street Address or POB#: ________________________________________________________
City: __________________________ State: _______ Zip ______________-____________
Email Address: _____________________________________________ O I wish to remain anonymous.

My gift is: (please circle)
In memory of/In Honor of
Name: ____________________________________________________________________

Birthday	Wedding	Anniversary	Graduation	Get Well
Thank You	Baptism	1st Communion	Confirmation	Bar/Bat Mitzvah
New Arrival	Holiday: ________________________________________________________
Other: __________________________________________________________________________

Please send acknowledgement of this gift to:
Name: ____________________________________________________________________
Street Address or POB#: ________________________________________________________
City: __________________________ State: _______ Zip ______________-____________

A letter of notification for this gift is sent immediately.

The amount remains confidential.

A copy of the official registration and financial information of the Greater Berks Food Bank may be obtained from the Pennsylvania Department of State by calling toll-free within Pennsylvania 1-800-732-0999, or by visiting the web site: www.dos.state.pa.us Registration does not imply endorsement.

Greater Berks Food Bank
1011 Tuckerton Court
Reading, PA 19605
610-926-5802
Fax 610-926-7638