| Contribute to NAMI Pennsylvania by Mail or Fax |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
Just print out and mail in the form below.
Yes! I want to Help NAMI Pennsylvania With a Tax Deductible Contribution
NAME_______________________________________________________________________
ORGANIZATION or AFFILIATE (if applicable)_____________________________________
ADDRESS________________________________________________________
CITY_____________________________________________________________
STATE____________________ ZIP______________
PHONE (home) _____________________ (work) ____________________
E-MAIL_____________________________________
__ Please find enclosed my gift: __ $500.00 __ $250.00 __ $100.00 __ $50.00 __ $10.00 __ Other $ _______
Payment Method:
Check (enclose)
Money Order (enclose)
Visa
Master Card
American Express
Discover
Account #____________________________ Exp. Date____________________
Card holder's Name ________________________________________________
Card holder's Signature______________________________________________
__ My company (or spouse's company) will match my gift, please contact me.
__ I would like to make a gift of stock to NAMI Pennsylvania. Please contact me.
__ I would like to include NAMI Pennsylvania in my will. Please contact me.
In the past, NAMI Pennsylvania has touched the lives of thousands of Pennsylvanians. None of it would have been possible without the
support of our donors- public and private, large and small.
Please help us continue to make a difference in the lives and health of families and
consumers in Pennsylvania.
I would like to target my gift to:
__ Providing education through Family-to-Family, Peer-to-Peer and other education programs.
__ Support general fund operations and special projects
__ In Honor of (name) _____________________________________________________
__ In Memory of (name) ____________________________________________________
Return to: NAMI PA, 2149 North 2nd St., Harrisburg, PA. 17110
1-800-223-0500
Yes! I want to Help NAMI Pennsylvania With a Tax Deductible Contribution
NAME_______________________________________________________________________
ORGANIZATION or AFFILIATE (if applicable)_____________________________________
ADDRESS________________________________________________________
CITY_____________________________________________________________
STATE____________________ ZIP______________
PHONE (home) _____________________ (work) ____________________
E-MAIL_____________________________________
__ Please find enclosed my gift: __ $500.00 __ $250.00 __ $100.00 __ $50.00 __ $10.00 __ Other $ _______
Payment Method:
Check (enclose)
Money Order (enclose)
Visa
Master Card
American Express
Discover
Account #____________________________ Exp. Date____________________
Card holder's Name ________________________________________________
Card holder's Signature______________________________________________
__ My company (or spouse's company) will match my gift, please contact me.
__ I would like to make a gift of stock to NAMI Pennsylvania. Please contact me.
__ I would like to include NAMI Pennsylvania in my will. Please contact me.
In the past, NAMI Pennsylvania has touched the lives of thousands of Pennsylvanians. None of it would have been possible without the
support of our donors- public and private, large and small.
Please help us continue to make a difference in the lives and health of families and
consumers in Pennsylvania.
I would like to target my gift to:
__ Providing education through Family-to-Family, Peer-to-Peer and other education programs.
__ Support general fund operations and special projects
__ In Honor of (name) _____________________________________________________
__ In Memory of (name) ____________________________________________________
Return to: NAMI PA, 2149 North 2nd St., Harrisburg, PA. 17110
1-800-223-0500
| |||||||||||||||||||||||||
