Give to Earth Share by Fax or Mail
Please print and fill out this form, then fax it (with your credit card information) to 240.333.0301 or mail it (with your check, money order or credit card information) to the address below.
Name: ___________________________________________________________________
Address: _________________________________________________________________
________________________________________________________________________
Home Phone: _________________________ Work Phone: _________________________
E-mail Address: ___________________________________________________________
I wish to contribute: $_____________ [ ] Please acknowledge my gift (complete address above).
[ ] Please distribute my gift to all Earth Share member organizations.
[ ] Please distribute my gift to the following organizations:
1. _____________________________________ $ _____________
2. _____________________________________ $ _____________
3. _____________________________________ $ _____________
[ ] I have enclosed a check payable to Earth Share.
[ ] I would like to make a donation by credit card. (Minimum $25)
[ ] Mastercard
[ ] VISA
Name as it appears on card: __________________________________________________
Credit Card #: ________________________________ Exp. Date: ___________________
Signature: ________________________________________________________________
For a gift of $250 or more, you must include your address for tax purposes.
7735 Old Georgetown Road, Suite 900
Bethesda, MD 20814
1.800.875.3863