Donating by Mail
With a Check or Credit Card

1. Print out this page and fill out the information requested (or simply mail a check to the address below if you don't have a printer)

2. Mail it to:

NumbersUSA
1601 North Kent Street
Suite 1100
Arlington, VA 22209-2105

A. Gift Amount 
Gift in US Dollars ________       I am donating by (circle one): 
                                  Enclosed check    Credit Card
B. Contact Information 
______________        _____________        __________________    
First Name            Middle Initial       Last Name

_____________________________________________________________
Address Line 1

_____________________________________________________________
Address Line 2

______________________         _____              ___________
City                           State              ZIP

______________________         ______________________
E-mail Address                 Phone
C. Credit Card Information 
___________________          ____ / ____
Credit Card Number           Expiration Date

Name on Card:

_________________    ______________          __________________     
First Name           Middle Initial          Last Name