Donor Form

Night Under the Stars Donation form

Can you help?

As many of you know, Arizona Network for PKU and Allied Disorders (ANPAD) has been a large part of my life for many years. Our goal as a nonprofit organization has been to help the people and families affected by rare metabolic disorders. This coming March, we will be hosting our annual Night Under the Stars fundraising event. Money raised from this event supports programs like Camp Knot-a-Phe. This is a summer camp for kids and their families, where they are taught ways in which to live with their condition (weighing out food, taking regular blood-draws etc.), while having a great time doing normal summer camp activities.

First Name:_______________________

Last Name:_____________________________

Company Name: ___________________________________________________________ Mailing Address:___________________________________________________ City:______________________Postal/ZIP:_________________________ Email Address:______________________________________________________________

Item or donation:
________________________________________________________________ expiration or other information: ________________________________________________

Donation Amount: ___$20 ___$50____ $100____ Other: _________

Please make your check payable to: Arizona Network for PKU and Allied Disorders ANPAD is a 501(c)(3) organization Tax ID# 27-4283489
West Windsor Goodyear, AZ 85395.

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