I Care Kentucky Mail-in Donation Form

Please print and complete this page and mail it with your check. 

___ I/we would like to contribute $________________ toward I Care Kentucky’s intersection safety efforts. 
___ My company would like to contribute $________________ to these safety efforts. 

Name: _______________________________________________________________________
Company Name (if applicable): ___________________________________________
Phone: (___) ______________
Street Address: _____________________________________________________________
City: ___________________________ State: ___________________ Zip: ______________

Make check payable to: I Care Kentucky
Mail to: 2712 Ashbrooke Drive, Lexington, KY 40513
Phone: (859) 435-1360

I Care Kentucky is a 501c3 non-profit organization and your contribution is tax deductible.