ONLINE DONATION FORM

Name: _____________________________________________

Address: ____________________________________________


Donation Enclosed: $___________________

Please make your checks payable to: Locust Valley Fire Department

Print out this form and mail with your check to:
Locust Valley Fire Department
Locust Valley
New York 11560

PLEASE NOTE: Door to door solicitations are not conducted by the Locust Valley Fire Department. Anyone seeking contributions directly should be reported to the Fire Department immediately.