Thank you for helping keep children safe.

  • Print this form
  • Fill out the requested information
  • Enclose your check or credit card information
  • Send it to:  Polly Klaas® Foundation
                     PO Box 800
                     Petaluma, CA  94953

Thank you so much for your kind and generous contribution.

Please select your gift amount:
     __$30
     __$50
     __$100
     __$1,000
     __ Other    $_________________


Please enter your contact information:

Email:________________________________________

First Name:____________________________________ 

Last Name:____________________________________

Address:______________________________________

City:__________________________________________

State: _________________  Postal Code:__________

Country:______________________________________

I would like to make my donation:

In memory of:______________________ In honor of:________________________

Please send acknowledgement to:_______________________________________

I would like to pay by:   _____check (please enclose)
                                  _____credit card

Card number:__________________________________

Expiration Date:  Month_________  Year___________

A receipt will be mailed to you. 

If you have any questions, please call us at: 800-587-4357.

Thank you,

The Polly Klaas® Foundation