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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