Contribution Form
__
I would like to help with the Men in Balance
effort. Enclosed is my check for:
Other
_____________
__
Contact me about other ways I might help.
__
Add me to the newsletter email list
Name
_____________________________
Address
___________________________
City
________________ State__________
Zip________
Phone__________________
Email
_____________________________
You may also contribute online!
(Address
on reverse side of this panel)
Another
person who might be willing to help:
Name
_____________________________
Address
___________________________
City
________________ State__________
Zip________
Phone__________________
Email
_____________________________
Thanks
for your help!!!
|
|
__
$50
|
__
$75
|
|
__
$100
|
__
$200
|
|
__
$250
|
__
$500
|
__
I would like to help with the Men in Balance
effort. Enclosed is my check for:
Other
_____________
__
Contact me about other ways I might help.
__
Add me to the newsletter email list
Name
_____________________________
Address
___________________________
City
________________ State__________
Zip________
Phone__________________
Email
_____________________________
You may also contribute online!
(Address
on reverse side of this panel)
Another
person who might be willing to help:
Name
_____________________________
Address
___________________________
City
________________ State__________
Zip________
Phone__________________
Email
_____________________________
Thanks
for your help!!!
|
|
__
$50
|
__
$75
|
|
__
$100
|
__
$200
|
|
__
$250
|
__
$500
|
To make a
credit card contribution, click here or
Complete and mail the form below:
__
I would like to help with the Men in Balance effort. Enclosed is my check for:
__
$50
__
$75
__
$100
__
$200
__
$250
__
$500
__
Other amount _________________
__
Contact me about other ways I might help.
__
Add me to the newsletter email list
Name
_____________________________________________
Address
___________________________________________
City
________________ State __________Zip ____________
Phone_____________________________________________
Email
_____________________________________________
You may also contribute online!
Mail
to Men in Balance 20908 N Main Cornelius, NC 28031
Another
person who might be willing to help:
Name
_____________________________
Address
___________________________
City
________________ State__________
Zip________
Phone__________________
Email
_____________________________
Thanks
for your help!!!
|