Survivors, Inc. Donation Form

Please print, complete and mail this form to:

Survivors, Inc.
Post Office Box 3572
Gettysburg, PA 17325

Donations are welcomed by Visa/MasterCard or check made payable to Survivors, Inc.:

_______$25 _______$50 _______Other Amount: ($_______________)

Name (as it appears on card) ____________________________________________________________

Billing Address _________________________________________________________________________

Credit Card Number ____________________________________ Expiration Date _________________

The official registration and financial information of Survivors, Inc. may be obtained from the Pennsylvania Department of State by calling toll free (800)732-0999. Registration does not imply endorsement. Our registration number is 3789.

Survivors, Inc. is a 510c3 nonprofit organization- donations to which are tax deductible to the fullest extent permitted by law.