Donation Mailer Form

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(Option A)

Enclosed is my check for $_______ made payable to PFOX. All donations are tax-deductible.

Name(s): _____________________________________

Address: ______________________________________

_______________________________________________

Email: __________________________________________

______ Yes, I would also like to volunteer for PFOX

Mail to: PFOX, Box 561, Fort Belvoir, VA 22060

(Option B)

Would you like to donate to PFOX every month? _________

Please charge my credit card on a monthly basis in the amount of $ _____________

Visa _______ MasterCard _______
Account # _____________________________
Expiration Date: ____/____/____
Signature: ______________________________

(Option C)

Monthly Automatic Direct Bank Payments: I hereby authorize Parents and Friends of Ex-Gays, Inc. (PFOX) to initiate debit entries to my bank account at the bank named below. I understand that my bank will transfer directly from my bank account to PFOX the amount I have designated below:
Bank Name: _________________________________________
Branch: _______________________________
City, State & Zip Code: __________________________________
Account Number: ___________________________
(Attach a voided check to this form)

Amount to be debited from your bank account
each month: $_________________

This authorization is to remain in effect until PFOX has received written notification from me of its termination and in such time as to afford PFOX and my bank a reasonable time to act on it. A record of my payment will be included in my regular bank statement and will serve as my receipt.
Donor Name: _____________________________________
Signature: ________________________________________
Date: _______________

(Option D)

Frequent Flyer Miles Needed: Please donate your frequent flyer miles to PFOX. With all the traveling we do, we can use them!

Matching Gifts: There are more than 5,000 companies that match employees� gifts made to nonprofit organizations like PFOX. Contact your employer�s Human Resources office to ask if your company has a matching gift program. If it does:
Obtain a Matching Gift Form from your Human Resources office
Fill out the form � Make your check payable to PFOX
Mail your check with the Matching Gift Form to PFOX

(Option E)

Stock: Donors can use securities to support PFOX. You can donate shares without having to pay capital gains on those shares and still write off the full current value of the shares. Please have your stockbroker notify us of the following information:
Brokerage name
Name and type of company stock
Number of shares to be donated
Current price per share (at the time of transfer)
Date of transfer to PFOX