Regional Log of Checks Received
Choose Your Region
Region I (CT, ME, MA, NH, RI, VT): Jose Sierra (Boston, MA)
Region II (NY): Matthew Fernandez Konigsberg (Brooklyn, NY)
Region III (NJ): Anna Maria Tejada (Hackensack, NJ)
Region IV (DE, PA): Lorena E. Ahumada (Philadelphia, PA)
Region V (DC, MD, VA, WV): Raymond Ramirez (Washington, DC)
Region VI (NC, SC): Gonzalo Frias (Charlotte, NC)
Region VII (AL, GA, MS): Enrique “Henry” Gimenez (Birmingham, AL)
Region VIII (FL): Araly Herrera (Coral Gables, FL)
Region IX (IL, IN, MI, WI): Luis Avila (Chicago, IL)
Region X (KY, OH, TN): Christian Gonzalez (Columbus, OH)
Region XI (IA, MN, MO, ND, SD): Joe Nuñez (Minneapolis, MN)
Region XII (AR, LA, OK, TX): Cynthia Sutherland (Plano, TX)
Region XIII (CO, KS, NE, WY): Jennifer Cadena (Denver, CO)
Region XIV (AZ, NV): Freddy Saavedra (Phoenix, AZ)
Region XV (UT, NM): Michelle Hernandez (Albuquerque, NM)
Region XVI (AK, ID, MT, OR, WA): Mick Konowal (Sammamish, WA)
Region XVII (Northern CA, HI): Natalie Pierce (San Francisco, CA)
Region XVIII (Southern CA): Lindsay Maria Holloman (Los Angeles, CA)
Region XIX (Puerto Rico): Grymarys De Jesus (San Juan, Puerto Rico)
What is your email?
What is your name?
Name of Payor (on the check)?
Date of the check
Total Amount on Check?
Check Number (Top right of check)
Purpose of the check (event)?
Date the check was sent to National?
Tracking number for check sent to National (i.e., USPS, FedEx, UPS, DHL, etc)
Send me a copy of my responses.
Please complete the captcha before submitting the form.
Never submit passwords through Google Forms.
This form was created inside of The Child Center of New York.
Terms of Service