A 501(c)3 Non-profit Educational Organization

 

ANNUAL GIVING CAMPAIGN CONTRIBUTION
 

Name

  

Address
City State Zip
Email

   Home Phone

   Work Phone

   Cell Phone

 

 

Please select your level of contribution
                  $3,000 **  -  Grand Patron                   $100 - $299  -  Sponsor
                  $1,000 **  -  Patron                   $50 - $99  -  Contributor
                  $500 - $999 **  -  Guarantor                   $25 - $49  -  Friend
                  $300 - $499  -  Benefactor                   $5 - $24  -  Student

                     ** A FREE signed copy of The Heart and Science of Yoga is yours at this level of contribution.

  Contribution Amount

If you would like to make an on-going pledge, please select an option below.

Bill Me:     Monthly

  Quarterly

   Annually

Amount of installment
 

     I would like to make a gift in honor/memory of someone.
              (Please fill in the name or occasion in the comment section below.)

     I would like my gift to remain anonymous.

     My company will match my gift.

Payment Method
Please select one:  Visa  MasterCard  American Express  Discover
Card Number 
Exp. Date 

 

 

 CVV2  (whats CVV2?)

 

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