AMDA Foundation - Make a Contribution to the AMDA Foundation

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Contributions

Make a Contribution to AMDA Foundation

Make a Contribution to the AMDA Foundation

Fields denoted with an asterisk (*) are required.

Section A - Contributor's Information

First Name: *

Middle Initial:

Last Name: *

Credentials:

Address 1: *

Address 2:

City: *

State: *

Zip Code: *

Phone: *

Please enter your primary telephone number using the format XXX-XXX-XXXX.

Fax:

Use the format XXX-XXX-XXXX.

Email: *

AMDA Member: *

Yes No
Are you an AMDA member?

Section B - Contributor's Preferences

Listing Options: *

Please list my name
Withhold my name from lists
Your name will be published in the list of contributors for the current year (see Fundraising/Contributions/200X Contributors) if you select Please list my name. Otherwise, select Withhold my name if you prefer to make an anonymous contribution.

Other Option:

My employer has a matching gift program

Section C - Contribution Selection

Contribution Levels:

The following contribution levels are used when listing your name as a contributor:

Supporter:	$25 - $99
Friend:	$100 - $249
Patron:	$250 - $999
Charter Club:	$1,000 - $4,999
Founders Club:	$5,000 - $9,999
Legacy Club:	Ongoing aggregates of $10,000 or more

Amount: *

$25 (minimum)
$50
$75
$100
$250
$500
$750
$1,000
Other

Other Amount:

Please enter an amount for other only if you selected "Other" above. Enter this amount using only whole numbers and without any punctuation i.e. "2000". The minimum contribution is $25.

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