Name:  _____________________________________________________

Street:  _____________________________________________________

City:  _______________________  State:  ______________  Zip:  ____________

Phone: _______________________________  Email:  ________________________________________

I want to pledge:  $ ______________________ All or nothing

I want to pledge   $ ______________________ Per pound

Please contact me about being a Kinship mentor:  _________________

Mail to:  Kinship Partners  

               Wellness Donation                                       

               910 Pine Street
               PO Box 642
               Brainerd, MN 56401