cash donation form

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D DONATION F FORM Thank you! The National Eating Disorders Association (NEDA) envisions a world without eating disorders – and your gifts help to make that a reality. Our mission is to support those affected by eating disorders and be a catalyst for prevention, cures and access to quality care. Your gifts help fund our national, toll-free helpline, website, research grants, age-appropriate prevention programs and National Eating Disorders Awareness Week. I will support the National Eating Disorders Association with a tax-deductible gift of... $1,000 $500 $250 $100 $37 $_____Other Please fill out all information below completely. Include your name or business name exactly as you would like it to appear in all official acknowledgments (print, electronic, etc...) More about my gift... I/we wish to remain anonymous. My company will match my contribution. (Please list company name:__________________________________________) This gift is in honor memory of (Name): __________________________________________________________ Please notify the honoree or family of my gift: Include names and addresses: ______________________________________ _______________________________________________________________________________________________ My gift is referred by (individual or event that prompted your gift): ______________________________________________ (Example: The St. Louis NEDA Walk organized by Jane Doe, 2/22/2008) For credit cards, please also provide the information requested below: Check (Made Payable to NEDA) American Express Visa MasterCard Card No.: Expiration Date: Name on card (Please Print): Signature: Billing Address (If Different From Above): NEDA is a 501(c)(3) nonprofit organization. Your gift is tax-deductible to the full extent of the law. Our federal tax id number is 13-3444882. NEDA 2008 Name: Title: Company: Street Address: City: State: Zip: Phone: Email: Web Address: Other: National Eating Disorders Association 603 Stewart Street, Suite 803, Seattle, WA 98101 Ph: 206-382-3587 * Fx: 206-829-8501* www.MyNEDA.org

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This is the form to use if you have someone who wants to give a cash donation.

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Page 1: Cash Donation Form

DDOONNAATTIIOONN FFOORRMM

Thank you! The National Eating Disorders Association (NEDA) envisions a world without eating disorders – and your gifts help to make that a reality. Our mission is to support those affected by eating disorders and be a catalyst for prevention, cures and access to quality care. Your gifts help fund our national, toll-free helpline, website, research grants, age-appropriate prevention programs and National Eating Disorders Awareness Week.

I will support the National Eating Disorders Association with a tax-deductible gift of...

$1,000 $500 $250 $100 $37 $_____Other Please fill out all information below completely. Include your name or business name exactly as you would like it to appear in all official acknowledgments (print, electronic, etc...)

More about my gift...

I/we wish to remain anonymous. My company will match my contribution. (Please list company name:__________________________________________) This gift is in honor memory of (Name): __________________________________________________________ Please notify the honoree or family of my gift: Include names and addresses: ______________________________________

_______________________________________________________________________________________________ My gift is referred by (individual or event that prompted your gift): ______________________________________________

(Example: The St. Louis NEDA Walk organized by Jane Doe, 2/22/2008) For credit cards, please also provide the information requested below:

Check (Made Payable to NEDA) American Express Visa MasterCard

Card No.: Expiration Date:

Name on card (Please Print):

Signature:

Billing Address (If Different From Above):

NEDA is a 501(c)(3) nonprofit organization. Your gift is tax-deductible to the full extent of the law. Our federal tax id number is 13-3444882.

NEDA 2008

Name: Title:

Company:

Street Address:

City: State: Zip:

Phone: Email:

Web Address: Other:

National Eating Disorders Association 603 Stewart Street, Suite 803, Seattle, WA 98101

Ph: 206-382-3587 * Fx: 206-829-8501* www.MyNEDA.org