Helen Keller National Center for Deaf-Blind Youths and Adults

HKNC Regional Representatives—There are 12 regional representatives located in offices throughout the United States. The regional representatives offer the following services to individuals who are deaf-blind and the agencies who serve them: consumer advocacy; consultation and technical assistance to schools and agencies; assistance in developing local services; consumer support as needed; information and referral; professional development and in-service training; public education and awareness; maintenance of a National Registry of Persons Who Are Deaf-Blind and information and enrollment in the National Deaf-Blind Equipment Distribution Program.Regional Offices: New England Region, Watertown, MA • Mid-Atlantic Region, Sands Point, NY • East Central Region, Laurel, MD • Southeast Region, Concord, GA • North Central Region, East Moline, IL • South Central Region, Austin, TX • Great Plains Region, Olathe, KS • Rocky Mountain Region, Denver, CO • Southwest Region, San Diego, CA • Northwest Region, Seattle, WAHeadquarters: 141 Middle Neck Road, Sands Point, NY 11050516-944-8900 VOICE 516-570-3626 VP

www.helenkeller.org/hknc 4/17

The Giving Tree

The Giving Tree was sponsored by the Peter and Jeri Dejana Family Foundation to commemorate HKNC’s 50th Anniversary (1967–2017).

CONTACT INFO:

Name

E-mail Phone

PAY BY:

CREDIT CARD

Credit card number Expiration date Security Code

Name on Card

Billing Address

City State Zip

Signature

CHECKPlease make check payable to HKNC and mail form to:HKNC, Development Department, 141 Middle Neck Road, Sands Point, NY 11050

PAY ONLINE at helenkeller.org/hknc

More information at 516-833-8310 or info@helenkeller.org

Be recognized!The Helen Keller National Center for Deaf-Blind Youths & Adults (HKNC) is offering an opportunity to become a member of our Giving Tree.

As a donor your name, or that of someone you would like to recognize, will be forever associated as a supporter of HKNC. When you make a contribution, your gift will be recognized by a leaf, rock or dove on or around a beautiful tree which is permanently displayed in the lobby of HKNC’s headquarters in Sands Point. Each donor’s plaque can be engraved to honor or pay tribute to someone you love. With your generous support, together we can help individuals who are deaf-blind live, work and thrive in the communities of their choice.

The Giving TreeLEAVESGold — $500Silver — $250Copper —$150

DOVES (8 Available)Gold — $1,500Silver — $1,250Copper — $1,000

ROCKS (4 Available)Gold — $2,000

Giving Tree FormNOTE: Please complete both sides of this form.

The Giving Tree elements will display the following:

LEAVES2 lines of text (28 characters per line, including spaces)1 line of braille (17 characters — surname)

Gold Enclosed is my contribution of $500 Silver Enclosed is my contribution of $250 Copper Enclosed is my contribution of $150

DOVES (8 Available)3 lines of text (28 characters per line, including spaces)1 line of braille (17 characters — surname)

Gold Enclosed is my contribution of $1,500 Silver Enclosed is my contribution of $1,250 Copper Enclosed is my contribution of $1,000

ROCKS (4 Available)4 lines of text (28 characters per line, including spaces)1 line of braille (17 characters — surname) Gold Enclosed is my contribution of $2,000

Total Amount Enclosed: $ ______________________

ENGRAVING:

1) _________________________________________________________________

2) _________________________________________________________________

3) _________________________________________________________________

4) _________________________________________________________________

BRAILLE: (17 characters — surname)

____________________________________________________________________

Please enter contact and payment details on reverse.