the NAILBA Charitable Foundation's 2017 fundraising Credit Card ...
The Marketing Alliance is pleased to support TMA distributors who are committed to improving the lives of those in need in our local communities by contributing to the NAILBA Charitable Foundation’s 2017 fundraising campaign. Our contribution plus your donation = a huge boost to the charities supported by grants from the NAILBA Charitable Foundation. Last year we raised more than $20,000—let’s do it again to help the Foundation have its best year yet! Contributions must be received at NAILBA by June 30 to be matched as part of this campaign. Count me in for _____ $250
_____ $500
_____ On my behalf
_____ $1,000
_____ Other: $______
______ On behalf of my organization
_____ I prefer to be listed as anonymous Donor Name:
_________________________________________________
Organization:
_________________________________________________
Address:
_________________________________________________ _________________________________________________
Phone:
_________________________________________________
Email:
_________________________________________________
Date:
_________________________________________________
Please make your check payable to the NAILBA Charitable Foundation. To make a donation with your credit card, please complete and return this form to the address below:
Credit Card Authorization Form Credit Card Type: Credit Card Number: Expiration Date:
_____ Visa
_____ MasterCard
_____ American Express
_________________________________________________ ________
Cardholder Name:
_________________________________________________
Billing Address:
_________________________________________________
City, State Zip:
_________________________________________________
Amount to Be Charged:
_____$250
_____$500
_____$1,000
_____ Other: $________
Authorized Signature of Cardholder: _________________________________________________ This form is a record of payment only. An official receipt will be forwarded when payment is processed. Donations to the NAILBA Charitable Foundation are tax deductible. Tax ID # 56-2448850.
NAILBA Charitable Foundation | 11325 Random Hills Road, Suite 110 | Fairfax, VA 22030 | www.nailbacharitablefoundation.org
_____ $500
_____ On my behalf
_____ $1,000
_____ Other: $______
______ On behalf of my organization
_____ I prefer to be listed as anonymous Donor Name:
_________________________________________________
Organization:
_________________________________________________
Address:
_________________________________________________ _________________________________________________
Phone:
_________________________________________________
Email:
_________________________________________________
Date:
_________________________________________________
Please make your check payable to the NAILBA Charitable Foundation. To make a donation with your credit card, please complete and return this form to the address below:
Credit Card Authorization Form Credit Card Type: Credit Card Number: Expiration Date:
_____ Visa
_____ MasterCard
_____ American Express
_________________________________________________ ________
Cardholder Name:
_________________________________________________
Billing Address:
_________________________________________________
City, State Zip:
_________________________________________________
Amount to Be Charged:
_____$250
_____$500
_____$1,000
_____ Other: $________
Authorized Signature of Cardholder: _________________________________________________ This form is a record of payment only. An official receipt will be forwarded when payment is processed. Donations to the NAILBA Charitable Foundation are tax deductible. Tax ID # 56-2448850.
NAILBA Charitable Foundation | 11325 Random Hills Road, Suite 110 | Fairfax, VA 22030 | www.nailbacharitablefoundation.org
