Name(s)______________________________________________________________________
Address:______________________________________________________________________
City________________________________________ State___________ Zip_______________
Phone ____-____-______ E-Mail __________________________________________________
DONATION LEVEL
$25 $50 $75 $100 $150 $275 $600 $1,000 $1,500 $_____________
In recognition of your support for the Atlanta Pride Committee:
-Name recognition on Atlanta
Pride Committee website
-Invitations to special Atlanta Pride Committee events
CREDIT CARD INFORMATION:
VISA/MasterCard/AMEX (circle one):
Card #______________________________________exp.date______________CVN#________
Name on Card_________________________________________________________________
Card Billing Address (if different than above)
Address:______________________________________________________________________
City________________ ______________________________State______ ZIP______________
OPTIONAL: I would like this donation to be listed as:
IN HONOR OF _________________________________________________________________
IN MEMORY OF _______________________________________________________________
_____ I WOULD
LIKE TO REMAIN ANONYMOUS
Please fax or mail your completed form to: (866) 766-9104
Atlanta Pride Committee, Inc, 1530 Dekalb Ave NE, Ste A, Atlanta, GA 30307
We now offer monthly installment plans for Friends of Pride Donors. If you
would like more information, please contact us in the office: (404) 382-7588
