To make a contribution to Crossworks, please print and fill out the following form (or enclose the following information with your contribution) and mail to the address below.

Name: ______________________________________________

Address: ___________________________________________
         
         ___________________________________________

         ___________________________________________

Email: _____________________________________________

Phone: (____)_______________________________________

Fax: (____)_________________________________________

Enclosed is my contribution of $____________
    (All contributions are tax deductible)

Make checks payable to Crossworks

Mail to:
Crossworks
P.O. Box 6795
Rocky Mount, NC 27802