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Meals On Wheels Of Shawnee and Jefferson Counties, Inc.
5724 SW Huntoon St.
Topeka, KS 66604
(785)670-2434


To make a contribution please print form, fill out, and mail in.


Select Contribution amount: $1,600 (one year for one client)
$800 (six months for one client)
$267 (two months for one client)
$133 (one month for one client)
Other(enter amount)___________


In memory of:__________________________________________________________________________

Family to be notified:_____________________________________________________________________

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Relation:_______________________________________________________________________________

Given by:_______________________________________________________________________________

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Phone:____________________

E-mail:____________________

Credit Card:     VISA     MASTERCARD

Card number:_______________________________________________________Exp. Date:__________