Donate by Mail
All members
To mail your check or money order, just print one of the forms below, fill out the information, and mail to: Latino Commission on AIDS, 24 W 25th Street, 9th Floor, New York, NY 10010. If you have questions, please call us at (212) 675-3288.
• Donation Form (PDF)
• Donation Form (Word)
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MAKE A DIFFERENCE!
Support the Latino Commission on AIDS
Thank you making a contribution to the Latino Commission on AIDS. Your support allows us to continue to highlight the effect of HIV/AIDS in our communities, to support organizations that work on the front lines in Latino neighborhoods, and to make sure that HIV/AIDS policy fully addresses the needs of Latino families affected by the epidemic. Read More
Commission supporters receive a subscription to our monthly Dimelo Newsletter and become part of our mailing list.
DONATION AMOUNT
$25 ____ $50 ____ $75 ____
$100 ____ $250 ____ $500 ____
Other $____
DONOR INFORMATION
Name/Title:___________________________________________________________________
Company:____________________________________________________________________
Address:_____________________________________________________________________
State:______________ City:__________________________ Zip:________________________
Phone:_________________________________ Fax:_________________________________
PAYMENT INFORMATION
___Check/Money Order Enclosed
___Please charge my credit card: __Visa ___MasterCard ___Amex
Name on Card_________________________________________________________________
Credit Card #__________________________________________________________________
Exp. Date_____________________________________________________________________
BILLING INFORMATION (if different from mailing address)
Address:_____________________________________________________________________
State:______________ City:__________________________ Zip:________________________
Phone:_________________________________ Fax:_________________________________
MAKE CHECK PAYABLE TO Latino Commission on AIDS
MAIL THIS FORM TO:
Latino Commission on AIDS, 24 W 25th Street, 9th Floor, New York, NY 10010. If you have questions, please call Elayne Monnens at (212) 675-3288.
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