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HOME > AOCS FOUNDATION >

AOCS Foundation Donation Form

NOTE: If you do not want to donate online by credit card, please print this page and fax, or mail, it back to the address at the bottom of this form.

Date: (mm/dd/yy)
First Name
Last Name
Title (optional)
Company (optional)
Address
City
State/Province
Postal Code
Country
Business Phone (optional)
Fax Number (optional)
E-Mail (optional)
Are you an AOCS member?	yes no
AOCS Member Number
I would like to join the Foundation Century Club	Century Club $100

One-time amount of $

Pledge amount of $ per year for year(s)

Please apply my gift to:

Campaign to Update Technology & Communication Products

Annual Fund (unrestricted)

I have included AOCS in my will.

I would like more information on Planned Giving Opportunities

Payment Information

I wish to pay by credit card.

Credit Card Number

Expiration Date
/

Name as Printed on Card

Signature: (retype name)
Signature must be the same as the name on the credit card:

To donate by mail, please print this form and, mail or fax this form to:
(make checks payable to: AOCS Foundation)

Amy Lydic
AOCS Foundation
P.O. Box 17190
Urbana, IL 61803-7190 USA
Phone: +1-217-693-4807
Fax: +1-217-693-4852

Donations to the AOCS Foundation are tax-deductible to the extent provided by law.

AOCS Foundation will respectfully keep your donation anonymous if that is your wish.

Thank you for your support!

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