Sign Me Up

I Want To Be Involved

If you would like to become involved, please fill out the following form and we will contact you as soon as possible.

Name:


First	Middle	Last

Address 1:

Address 2:

City:

State:

Zip Code:

E-Mail:

Phone #:

Please indicate areas of interest:

	Volunteer for field trips.
	Volunteer to serve breakfast and lunch at the Summer Youth Project.
	Volunteer to share my talents as a tutor, mentor or camp counselor.
	Donate in-kind items: school and art supplies, books, computer and sports equipment.
	I would like to make a donation in the amount of $ Please make checks payable to House of Mercy and send to 725 Hudson Avenue, Rochester, NY 14621

Are there other areas, not listed above, in which you could contribute?