Print this Form to Contribute By Mail

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To send a check, money order or make a credit card contribution BY MAIL please print this form, fill it out, and mail it along with your donation to:
The Senior Citizens League
909 N. Washington St. #300
Alexandria, VA 22314
WDM1A1

Title: ____ First Name: _______________ MI: ___ Last Name: ____________________

Mailing Address Line 1: ___________________________________________________

Mailing Address Line 2 (if needed): ___________________________________________

City: ____________________________________ State/Province ________

Zip/Postal Code ________________ Country ________________________

Email Address: ________________________________________________

I'm making the following contribution to join with you and other TSCL members and supporters to help your nationwide grassroots campaigns for a Fair and Accurate Cost-of-Living Adjustment, Notch Reform, Prescription Drug coverage and other issues of importance to senior citizens:

$10   $15   $25   $40   $__________ (other)

Contributions or gifts to The Senior Citizens League are not deductible as charitable contributions for Federal income tax purposes.  Contributions are voluntary, and  no government funds are accepted.

The League's newsletter, The Social Security & Medicare Advisor, is available via e-mail.  This newsletter is packed with useful information and supporters tell us they regularly obtain helpful and money-saving information from it. Recipients of the newsletter via e-mail will also receive Legislative Alerts via e-mail in the event there is important legislative activity on Social Security & Medicare related legislation. 

[  ] Please send me The League's newsletter, The Social Security & Medicare Advisor, by e-mail.  Please print your e-mail address below:

___________________________________________________ 

__ I am enclosing a check payable to "TSCL".
__ I am providing the information below to make my donation using my credit card.
Credit Card Type: Visa Mastercard American Express Discover Card
Credit Card Number: _____________________________________
Exp Date: _________
Signature: _________________________________________________

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Copyright © 2007 The Senior Citizens League  |  703-548-5568  |  909 N. Washington St. #300, Alexandria, VA 22314
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