Make a tax-deductible donation to the Florida Keys Healthy Start Coalition.

Because we value your support and want to protect your information, we do not have an online credit option at this time. If you would like to pay by credit card, please download this form, print, complete your credit information, and FAX to (305) 293-8542.

We will have a Paypal and credit card option available soon. If you would like to donate via check, please complete the form below and mail your check to:

Florida Keys Healthy Start Coalition • 1100 Simonton Street Key West, FL 33041

Name:
Street Address
City, State
Zip
Contact phone number:
Email Address:
Primary contact phone number:
Yes, I would like to make a tax deductible donation.	$1000 Prenatal care for one mother $ 500 Counseling for postpartum mom $ 250 Car seat and stroller $ 100 Childbirth education class series $ 50 Diapers and necessary baby care items $ Other
If you selected Other, please indicate how you would like us to disperse your donation.
Dollar amounts are representative of these examples of services.