ACBVI | Mail-In Donation Form

Now more than EVER , YOU can make a difference!

2011 ACBVI Annual Campaign
Donation Form
Arizona Center for the Blind and Visually Impaired
3100 E. Roosevelt St.
Phoenix, AZ 85008
(602) 273-7411

Today's Date:

Your Information
Name:
Address:
City
State
Zip Code
E-mail:
Home Phone:
Cell Phone:

I am supporting the work of ACBVI with a gift of:
$1000 $500 $250 $100 $50 Other $
Please apply $200 (Single/Head of Household) $400 Married, filing joint Other $ of my donation to the Charitable Organization Tax Credit
Check or Money Order in US Funds is Enclosed:

After you have typed in your information, you may print this form by selecting Ctrl-P. Our mailing address can be found at the top of this form.

Thank you for your very generous donation to the
Arizona Center for the Blind and Visually Impaired.

ACBVI depends on your generosity!