Gail Devers Foundation - How You Can Help

You can help by making a tax deductible contribution to Gail Devers Foundation, Inc. Please complete the form below, print and mail or fax to:

Gail Devers Foundation, Inc.
5415 Sugarloaf Parkway, Suite 2206
Lawrenceville, GA 30043
Fax to 770.822.1991

First Name:

Last Name:

Street Address:

City:

State:

Zip/Postal Code:

Country:

Email Address:

Please apply my funds to the following program(s):

Capital Fundraiser:	General Operations:	Change for Change:
Holiday of Cheer:	Club Force:	Scholarship Program:
$15 $25 $50 $75 $100

Enclosed is my check:
Company Matching Gift Program:

Company Name:
Company Address:

Please charge my credit card:

Credit Card #:
*CV V: Expires:
Card Type: Visa Master Card

Signature: ________________________________
*The three numbers on the back of your credit card to the right of your card number

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Modified 8/2001 by