ACEER Donation Form

YES! I want to make a tax-deductable donation to the ACEER Foundation.

Name:_______________________________________________________________________________________

Address:____________________________________________________________________________________

City, State, Zip:________________________________________________________________________________

Phone:______________________________(home)      __________________________________ (cell)

E-mail:________________________________________________________________

Please indicate you donation level:

You can designate your donation to a specific program.  Please identify the program(s) below that you wish to support and the amount of your gift:

My check for $___________is enclosed payable to the ACEER Foundation

Please charge my credit card $_______________(total)        $____________________(monthly)

VISA   MasterCard  #_____________________________________________  Exp.____________________

3-Digit Pin: _____________________________

Signature: _______________________________________________________________________________________

_____My company will match my gift.  Company name: ____________________________________________

_____ I would like to receive the ACEER newsletter and other publications

Thank you very much for your support!!!

Please mail your check made payable to:
The ACEER Foundation
P.O. Box 2549 - WCU
West Chester, PA 19383