Recent studies show that 1 in 91 children is diagnosed with autism. For all the children and families affected by this disorder -- and all those who will be -- the time to act is now.  Your contribution will give a HAND to families who are trying to heal via biomedical treatments that are not covered by insurance. With your support, we will transform a community of heartbreak into a community of hope. * = required information  

 Donation Form Please print and then mail form

I would like to give to:*  Donation Amount* $ ______________
First Name*  ____________________________________________
Last Name*  ____________________________________________
Street Address* ______________________________________________________

City* ______________________________________State*___ Zip Code*________

Phone Number _____________________ E-mail ___________________________
I prefer to make my donation by:
       ___ Check or Money Order (made out to "Shapiro's HAND")
       ___ Credit Card (please enter information below)
__ American Express       ____ Discover       ____ MasterCard        ____ Visa
Credit Card Number ________________________________  Exp. Date _________
Signature ___________________________________________________________

Please mail your gift to:

2464 Headhouse Sq S, Bensalem PA 19020

Thank you for your gift